Endoscopic reduction of gastric volvulus: The alpha-loop maneuver

Abdominal pain with a twist: a rare presentation of acute gastric volvulus

“…Alpha-loop maneuver was successfully reported to reduce 7 out of 8 cases of gastric volvulus by David et al [13] All patients in this study presented with acute symptoms and 7 out of the 8 later underwent surgical repair, one patient continued to do well without surgery 1 year post procedure but died of other causes. Despite endoscopic resolution of acute gastric volvulus with symptomatic improvements patients who are suitable candidates for surgery need elective surgery to repair the underlying hernia [13]. Endoscopic de-rotation was initially attempted in our patient but could not be accomplished.…”

“…It has been reported more commonly for cases of chronic gastric volvulus. The techniques that have been suggested include the J-shape maneuver, extended J-shape maneuver, alpha-loop maneuver, and non-specific rotational maneuvers [13]. Alpha-loop maneuver was successfully reported to reduce 7 out of 8 cases of gastric volvulus by David et al [13] All patients in this study presented with acute symptoms and 7 out of the 8 later underwent surgical repair, one patient continued to do well without surgery 1 year post procedure but died of other causes.…”

“…The techniques that have been suggested include the J-shape maneuver, extended J-shape maneuver, alpha-loop maneuver, and non-specific rotational maneuvers [13]. Alpha-loop maneuver was successfully reported to reduce 7 out of 8 cases of gastric volvulus by David et al [13] All patients in this study presented with acute symptoms and 7 out of the 8 later underwent surgical repair, one patient continued to do well without surgery 1 year post procedure but died of other causes. Despite endoscopic resolution of acute gastric volvulus with symptomatic improvements patients who are suitable candidates for surgery need elective surgery to repair the underlying hernia [13].…”

Eventeration of the diaphragm with a gastric volvulus

“…The most widely accepted approach is repair via an abdominal (subcostal) incision because this allows ready access to both hemi-diaphragms for plication, permits anterior gastric fixation via a gastropexy or gastrostomy, and allows abdominal exploration for associated gastrointestinal anomalies [8]. Recently, endoscopic reduction of the gastric volvulus has been reported [9] with reports of percutaneous endoscopic gastropexy (PEG) [10] and laparoscopic gastropexy [10] for gastric volvulus.…”

Managing obstructive gastric volvulus: challenges and solutions

“…Options for management include endoscopic, laparoscopic, combined laparoendoscopic techniques, and open procedures. 3,4,[6][7][8] Manual reduction of the volvulus to relieve gastric obstruction is straightforward; however, without fixation of the stomach in its normal unobstructed orientation, recurrence of volvulus is almost guaranteed. There are two main options for prevention of recurrent volvulus: gastropexy and PEH repair.…”