Volvulus gastrique: diagnostic et prise en charge thérapeutique

Acute Organo-Axial Gastric Volvulus – A Complication of AntiReflux Surgery

“…Gastric volvulus is defined as an abnormal rotation of all or part of the stomach by with respect to one of its axes, thus creating the conditions for a high occlusion with dilation gastric and risk of strangulation. Taking into account the axis of rotation we can have two types of volvulus: the organo-axial volvulus and mesenterico-axial volvulus [5,6].…”

“…[9] In term of sex it appears to be a feminine predominance while a male predominance was reported by some authors. [10,5] This condition is mainly confined to elderly subjects with a peak in frequency around the fifties [5.11] [6, 10,12,13] but cases of children with congenital diaphragmatic anomalies or rarely asplenia have been reported [5,12,13].…”

“…It is contraindicated in the presence of signs of necrosis or gastric perforation. This exploration is often incomplete due to gastric torsion, which hinders the progression of the endoscope [5]. Progressive ischemic ulceration, or mucosal fissuring suggests late stage disease with strangulation [6] Some authors have reported a therapeutic interest in gastroscopy that allows endoscopic detorsion or even endoscopic guidance of percutaneous gastropexy.…”

“…Progressive ischemic ulceration, or mucosal fissuring suggests late stage disease with strangulation [6] Some authors have reported a therapeutic interest in gastroscopy that allows endoscopic detorsion or even endoscopic guidance of percutaneous gastropexy. [19] Surgery is the treatment of choice for gastric volvulus. It is indicated, particularly in cases of painful patient with CT signs of parietal gastric ischemia or perforation, or for a patient in septic shock.…”

Un cas de volvulus aigu de l’estomac chez l’adulte

“…Le volvulus gastrique est défini par une rotation anormale de tout ou partie de l'estomac par rapport à l'un de ses axes créant ainsi les conditions d'une occlusion haute avec dilatation gastrique et risque d'étranglement. Tenant compte de l'axe de la rotation, on différenciera le volvulus organo-axial et le volvulus mésentérico-axial [1,2]. Il s'agit d'une maladie rare, en raison de la solidité de ses moyens de fixation, représentés par quatre ligaments : gastro-colique, gastro-splénique, gastro-hépatique, et gastro-phrénique Cependant, sa fréquence est probablement sous-estimée car des formes spontanément résolutives sont possibles [3].…”