Acute gastric volvulus: A vicious twist of tummy-case report

Abstract

HighlightsAcute gastric volvulus is an uncommon surgical emergency requiring timely action.High index of clinical suspicion needed for diagnosis.Early intervention can save lives and lessen the associated high mortality.Primary gastric volvulus may be associated with general laxity of ligaments.Primary gastric volvulus may be linked to fibrosis in active pulmonary tuberculosis.

Second-look laparostomy for perforated gangrenous gastric volvulus to prevent total gastrectomy

“…This is, however, associated with recurrence rates of up to 64% 33. Reported options for definitive therapy in AGV include total or partial gastrectomy, anterior gastropexy, Tanner’s operation, Opolzer’s operation and Nissen fundoplication with or without Collis gastroplasty 4. This patient had hiatal repair and anterior gastropexy.…”

Acute Organoaxial gastric volvulus: A massive problem with a twist-case report

“…The stomach is anchored by the gastrohepatic, gastrosplenic, gastrophrenic, and gastrocolic ligaments [7] . Disruption, agenesis, or elongation of the ligaments may lead to the failure of these ligaments to support the stomach, which would lead to primary gastric volvulus [2] , [4] , [7] .…”

“…The secondary form is attributed to a defect in the gastric anatomy as well as gastric dysfunction, it can be also a result of disorders of adjacent organs such as the spleen and the diaphragm [7] , or other intra-abdominal factors such as left diaphragmatic eventration, adhesions, gastric ulceration as well as gastric or duodenal cancers [4] . Para-esophageal hernia is the most common association with gastric volvulus in adults, however other associations have been reported such as phrenic nerve paralysis and traumatic defects [2] , [7] .…”

“…The symptoms may mimic that of gastritis, cholecystitis, peptic ulcer disease, or even angina pectoris [6] . A chronic GV can manifest as atypical chest pain with a negative cardiac workup, anemia (most likely due to Cameron erosions), weight loss, and nonspecific symptoms including dyspnea, reflux, bloating [4] , dyspepsia [2] , intermittent abdominal pain after eating [2] , [7] and dysphagia which will go unnoticed usually [2] . These symptoms may diminish spontaneously that may cause a delay in diagnosis and treatment [2] .…”

“…If not diagnosed and treated early, gastric volvulus may lead to severe complications including gastric ischemia and necrosis, perforation of the stomach, omental avulsion, pancreatic gangrene, and in a few cases splenic rupture [2] . This medical condition’s high mortality rate (30%-50%) indicates an emergent accurate diagnosis followed by appropriate intervention to avoid aforementioned complications [2] . This work has been reported in line with the SCARE criteria [3] .…”