Gastric dilation - Ikakucho

When the stomach's muscular layer relaxes and loses its ability to contract, the stomach becomes a relaxed, expanded pouch. Evacuation of stomach contents is impeded, and secretions and ingested materials accumulate, causing the stomach to reach a considerable size. As a cause of acute gastric dilatation, which is seen after surgery, especially laparotomy, anesthesia, or trauma, recent advances in anesthesia and fluid therapy have significantly reduced the incidence. From an internal medicine perspective, it occurs secondary to organic pyloric stenosis due to peptic ulcers or cancer in the pylorus or duodenum, and is also seen in cases of chronic general weakness due to infection, sepsis, uremia, drug poisoning, cirrhosis of the liver, cancer, and other conditions. Recently, there has been an increase in gastropathy occurring in association with diabetes.

It is seen in about 0.1% of all gastrointestinal diseases. Symptoms include persistent vomiting, dehydration, and circulatory disorders. Diagnosis is by abdominal X-ray, which shows a dilated stomach and stagnation of gastric contents, and often also reveals an underlying disease causing pyloric stenosis. Treatment involves continuous suction of gastric contents, simultaneous administration of fluids and electrolytes, injection of gastric motility stimulants, and treatment of the underlying disease.

[Hisayuki Masuda and Hiromichi Arakawa]

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

胃の筋層が弛緩(しかん)し、収縮力を失った状態で、胃は無緊張の拡張した袋となる。胃内容の排出が障害され、分泌液、摂取物が貯留し、胃は著しい大きさに達する。病因として、手術ことに開腹手術、麻酔あるいは外傷後にみられる急性胃拡張は、最近の麻酔、輸液の進歩により著しく減少した。内科的には胃の幽門部や十二指腸の消化性潰瘍(かいよう)あるいは癌(がん)などによる器質的幽門狭窄(きょうさく)に続発するもの、また感染症、敗血症、尿毒症、薬物中毒、肝硬変、癌などの慢性全身衰弱のときにみられる。最近は糖尿病に併発する胃症が増加している。

　全消化管疾患の約0.1％にみられる。症状は、頑固な嘔吐(おうと)が持続し、脱水症状、さらに循環障害をきたす。診断は腹部X線検査で、拡張した胃と胃内容の停滞の証明、また幽門狭窄をきたす原疾患が証明されることも多い。治療は、持続的に胃内容を吸引し、同時に輸液と電解質の補給、胃運動亢進(こうしん)剤の注射で、同時に原疾患の治療をする。

［増田久之・荒川弘道］

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