Gastric volvulus: An uncommon and life threatening cause of acute gastric dilatation in a young male: A case report (original) (raw)
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GASTRIC VOLVULUS: A Case Report and Literature Review
Surgical Science, 2020
Background: Gastric volvulus is a rare surgical emergency that causes an upper digestive obstruction due to a rotation of the stomach greater than 180˚. Observation: We report the case of a 2-year-old patient referred from a health care facility for incoercible vomiting. On admission, the clinical examination revealed that the condition started about 1 month back with poor general and nutritional condition. Pyloric stenosis was suspected but this hypothesis was rejected based on abdominal ultrasound. Further investigations were done with an abdominal X-ray and an upper gastrointestinal barium study which led to the conclusion of an organo-axial gastric volvulus. The patient died in the course of treatment. Conclusion: Gastric volvulus is an often-misunderstood condition. Upper gastrointestinal barium study remains the gold standard of diagnosis. Its management is surgical.
Gastric volvulus: A review of 38 cases
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 2009
Gastric volvulus -a review of 38 cases ABCD Arq Bras Cir Dig 2009;22(2):96-100 ABSTRACT -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. HEADINGS -Stomach. Gastric volvulus. Surgery. Hiatal hernia.
Gastric Volvulus: A Challenge to Diagnosis and Management
2020
Introduction: Gastric Volvulus (GV) is a rare disease. The exact incidence of GV is unknown and patients with a chronic presentation may never be diagnosed. The peak age group of incidence is in the fifth decade. The volvulus can be classified as organoaxial and mesenteroaxial. The clinical presentation of gastric volvulus depends on the degree of rotation and the rapidity of onset. Case Presentation: An 86-year-old man came to the emergency department presenting with abdominal pain of 48-h progression with dyspnea, nausea with no vomiting. Nasogastric tube placement was unsuccessful. An abdominal computed tomography scan was revealed a volvulus gastric with pneumoperitoneum. Emergency surgery was indicated and a typical gastrectomy was performed. Conclusion: Acute GV usually presents with Borchardt’s triad. With the advent of CT and laparoscopic surgery, the gold standards for diagnosing and treating this disease are ever evolving. Surgical treatment should be performed according t...
Acute Gastric Volvulus: Diagnosis and Management over 10 Years
Digestive Surgery, 2006
Background/Aims: Gastric volvulus is a rare, potentially lifethreatening condition, which is difficult to diagnose. This study represents a series of patients with acute gastric volvulus. Methods: All patients presenting with acute gastric volvulus over a 10-year period were reviewed. Results: Twenty-one patients with a median age of 66 years were identified. Acute gastric volvulus was secondary to a paraesophageal hiatus hernia in 16 patients. The major symptoms were abdominal pain, vomiting and upper gastrointestinal bleeding/anemia. The most useful investigations were barium studies and upper gastrointestinal endoscopy. Treatment was open surgery in all patients. There were no major complications and no deaths. Median hospitalization was 8 days. Conclusion: Acute gastric volvulus is a rare condition which requires a high index of suspicion for diagnosis, which is usually based on imaging studies. The treatment is immediate surgery. Volvulus can be treated successfully by open surgery with minimal morbidity and short hospitalization.
Gastric volvulus and attendant complications
Annals of African Surgery, 2019
The diagnosis of a hiatal hernia, a gastric volvulus or its attendant complications, can be easily missed because evaluation of acute abdominal pain can be difficult, particularly in resource-limited settings. Diagnosis of a gastric volvulus is even harder in the pediatric population because its peak occurrence is in the fifth decade. Hiatal hernia (and gastric volvulus) can be found incidentally in chest radiographs that are requested routinely or in suspected pulmonary pathology. The gold standard diagnostic tool for a gastric volvulus is a barium swallow. The optimal treatment method is open laparotomy with detorsion, and prevention of recurrence with anterior gastropexy. We present a case of an 8-year-old girl who had a diagnosis of hiatal/paraesophageal hernia with a gastric volvulus complicated by ischemia, necrosis, perforation and collapse of the left lung. A complete history and a thorough evaluation of the sick-looking patient are paramount in diagnosing life-threatening conditions like gastric volvulus.
Gastric Volvulus: A Multidisciplinary Approach and Conservative Treatment
Cureus, 2021
Gastric volvulus can be defined as an abnormal rotation of the stomach. It can be both an emergency and a chronic intermittent problem. Being such a rare clinical entity and a difficult condition to diagnose, it is commonly diagnosed at the time of surgery or even at autopsy. We present the case of an 82-year-old independent female with a past medical history of hiatal hernia, who came to the emergency department with hematemesis and severe epigastric pain. An abdominal CT scan revealed an organoaxial stomach volvulus within the intrathoracic cavity. After initial treatment with gastric decompression, IV fluids and proton pump inhibitors, the patient was informed that the surgical intervention would be the only definitive curative treatment for her condition and denied the procedure. She was then discharged after clinical and analytical improvement. She was offered a conservative treatment and follow up by the internal medicine team. After a few months, the patient reported moderate improvement of her symptoms and less episodes of epigastric pain. She was pleased with the conservative management and denied any surgical or invasive procedures. A proximity contact was established with the family doctor, which she maintains. This case report is proof that rare entities can happen to patients presenting common symptoms and better resolutions come from multidisciplinary approaches.
Acute gastric volvulus: an uncommon presentation
Revista argentina de cirugía, 2021
Acute gastric volvulus: an uncommon presentation El vólvulo gástrico agudo (VGA) es una entidad infrecuente, con elevada mortalidad de hasta 50%, y su diagnóstico se basa en un alto nivel de sospecha clínica. En el paciente estable se puede plantear manejo no operatorio, pero en el inestable se impone el tratamiento quirúrgico. Presentamos el caso de un paciente con VGA e inestabilidad hemodinámica, en el cual se realizó laparotomía y devolvulación gástrica, pero falleció en el posoperatorio inmediato por shock refractario.
Internal and Emergency Medicine
An 18-year-old man presented with complaints of sudden onset pain in the epigastrium radiating to the left lower chest, starting 7 days prior followed by non-productive and persistent retching. On examination, the patient had a tachycardia (pulse rate 108 beats/min) and a blood pressure of 102/66 mmHg. His respiratory rate was 22 breaths/min and was afebrile. On chest examination, air entry was markedly reduced on the left side. The abdomen was not distended; an ovoid-shaped tender organ was felt in the epigastrium. The rest of the abdominal examination was normal. A single gentle attempt of nasogastric tube insertion was done, but insertion beyond the first mark was not possible. A plain X-ray study of the chest and abdomen done earlier showed a double bubble sign ( , Contrast films showed a dilatated and tortous dumbbell-shaped stomach overlapping the left lower chest . Although a computed tomography (CT) scan of the abdomen would have been preferable, the barium study had been done before the patient was referred to us .
Gastric volvulus in adults in a tertiary care hospital Karachi, Pakistan: a case series
Journal of the Pakistan Medical Association, 2020
Gastric volvulus is a rare surgical emergency which mostly presents in children and occasionally in adults. It results due to pathological malrotaion of the stomach along its longitudinal or short axis. The condition, if not treated promptly, can result in increased morbidity and caries a high risk of death. Very few cases have been reported in literature regards this important clinical condition. Early decompression and repair of anatomical defects are the corner stone of its management. There is a dire need to develop guidelines and algorithms for management and treatment of this rare condition to improve patient outcome, prevent recurrence and facilitate early diagnosis by practicing physicians and surgeons. We report three such cases which presented to our setup in emergency along with a brief description of how they were successfully managed. Keywords: Gastric Volvulus, Malrotation, Vomiting, Continuous...
International Surgery Journal
Gastric volvulus is nothing but the torsion of stomach in thoracic cavity by more than 1800 along its transverse or longitudinal axis. A very rare case occurring both in male and female. The term first described by Berti after doing an autopsy of a female, in 1886. We found a case of 65 years old male with history of dyspepsia since, 1 year with history of vomiting and pain abdomen since, 1 day. On evaluation, clinically gurgling sound heard on left side chest and with investigations like USG and CT whole abdomen, we came to know about mesentrico axial volvulus which is more common in children. Acute gastric volvulus cases have high mortality rate also requires emergency surgery. Gastric volvulus is very rare with variable and non-specific clinical presentations, hence high level of suspicion for radiologic diagnosis may require. Acute gastric volvulus is a potentially life-threatening occurrence with a good outcome when treated in a timely fashion. Chronic volvulus may be more diff...