Neonatal gastric volvulus

Jb, Campbell

doi:10.2214/ajr.132.5.723

Cited by 23 publications

(9 citation statements)

References 1 publication

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“…Gastric volvulus is more likely to occur in the fifth decade of life (in this study, in the third decade as well), and it occurs with the same frequency in both genders (1.3 males to 1 female in this series) 3,10,12,20,21,29,32,3334 . Its clinical presentation can be in an acute form with a variable degree or in a chronic form with uncertain and sporadic dyspeptic symptom supremacy 3,21 .…”

Section: Discussionsupporting

confidence: 48%

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Gastric volvulus: A review of 38 cases

Jacob¹,

Lopasso²,

Zilberstein³

et al. 2009

ABCD, arq. bras. cir. dig.

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BACKGROUND: Gastric volvulus is frequently an asymptomatic disease, and it is usually diagnosed during radiographic examination of the superior digestive tract. The acute form, however, can spawn serious and lethal clinical consequences. This disease is defined by the anomalous rotation of the stomach over itself, and it can be classified according to type, extension, direction, etiology, and clinical presentation. AIM: To review the records from 38 patients with gastric volvulus diagnosed in the Hospital das Clínicas of University of São Paulo between 1968 and 2001. METHODS: This is retrospective analysis of 38 patient records. It was collected from each patient: name, age of first symptom appearance, gender, main clinical findings and complementary exams, volvulus type, extension, direction, etiology, and clinical presentation, therapeutic procedures, type of surgery performed, eventual recurrence, and long-term evolution. RESULTS: It was observed that occurrences of gastric volvulus are mainly secondary (75.8%). For the majority of patients (n=33), surgery was chosen as the treatment option: chronic disease in 29 cases and acute in four. Conservative treatment was reserved only for patients with no clinical conditions to surgical treatment. Anterior gastropexy was associated to high recurrence rates. Suturing the low gastric curve to the hepatic capsule and the transverse colon to the left subphrenic space (Tanner´s operation) seemed to be the technical treatment of choice for primary gastric volvulus. CONCLUSION: Treatment of gastric volvolus must be tailored according the etiology of the disease.

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Section: Discussionsupporting

confidence: 48%

“…Primary gastric volvulus represents 30% of the cases related in the literature and is more common in adults, although it was initially described in children 12,16 . It was observed a similar frequency of occurrence in this study, where secondary volvulus was predominant in the operated cases (75.8%).…”

Section: Discussionmentioning

confidence: 99%

Gastric volvulus: A review of 38 cases

Jacob¹,

Lopasso²,

Zilberstein³

et al. 2009

ABCD, arq. bras. cir. dig.

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“…The stomach is supported in its normal position by the gastrocolic, gastrosplenic, gastrohepatic and gastrophrenic ligaments as well as the anchorage of the retroperitoneal duodenum and at the oesophageal hiatus 5. Congenital absence or abnormalities of these ligaments has been implicated in the aetiology of volvulus development 6 7. On the other hand, the volvulus may be secondary to splenic or diaphragmatic conditions as detailed by Cribbs et al 8 in figure 4.…”

Section: Discussionmentioning

confidence: 99%

A twist in the tale

2013

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A 4-year-old girl presented with retching and abdominal colic and was initially diagnosed with gastroenteritis. However, progressive pain and epigastric distension led to a surgical review and she was discovered on CT scanning to have a gastric volvulus. She required urgent laparotomy to decompress the stomach and repair a perforation on the lesser curvature. Her recovery was complicated by sepsis and reperforation necessitating further laparotomy, at which time she also underwent gastropexy. The patient required long-term jejunal feeding in the hospital and at home before finally returning to normal diet and activity.

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“…Gastric volvulus is precisely that, a rotation of all or part of the stomach about either a longitudinal (organoaxial) or vertical (mesenteroaxial) axis by at least 180°C such that the rotation is sufficient to cause foregut obstruction on an acute, intermittent or chronic basis. It is thought to be caused by a disorder of the ligaments that normally maintain the stomach in the correct anatomical position 2 – 4. While acute gastric volvulus is a surgical emergency, the chronic form may often be managed conservatively and there is currently no consensus in the literature as to when to do which.…”

Section: Discussionmentioning

confidence: 99%

Management dilemma in a paediatric patient with chronic gastric volvulus: a case report

Norrington

Reynolds²

2009

Case Reports

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Gastric volvulus in children is rare. While the acute form is a surgical emergency, the chronic form may be managed either surgically or conservatively. The present report describes a premature (26+1 weeks) Afro-Caribbean neonate girl who presented with severe multiple bradycardias and apnoeas; she subsequently underwent pH monitoring and a barium study which demonstrated gastro-oesophageal reflux disease (GORD) and gastric volvulus. The patient represented a management dilemma as there were delays in establishing the diagnosis since medical treatment was started before pH monitoring was performed, and because of complications of prematurity precluding surgical treatment. This case supports an association between GORD and gastric volvulus while arguing that the mode of treatment should be based upon the severity of symptoms. This case is of particular interest to paediatricians who might consider this diagnosis in infants presenting with non-specific gastrointestinal and feeding problems particularly in association with GORD.

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Neonatal gastric volvulus

Cited by 23 publications

References 1 publication

Gastric volvulus: A review of 38 cases

Gastric volvulus: A review of 38 cases

A twist in the tale

Management dilemma in a paediatric patient with chronic gastric volvulus: a case report

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