Published on April 8, 2014
Pediatric Gastric Volvulus Rebecca Starr, D.O. PICU Review 4/8/14
What is Gastric Volvulus? • Twisting of all or a portion of the stomach at least 180° about an axis that causes an obstruction of the foregut • Rare in children • Acute, intermittent, recurrent, or chronic • Acute gastric volvulus • Life- threatening occurrence • Good outcome when treated quickly • Chronic volvulus may be more difficult to recognize
Volvulus Etiology • Ligament abnormalities • Abnormalities of gastric anatomy or gastric function • Abnormalities of adjacent organs • Diaphragm • Spleen • Transverse colon • Intestines • Liver
Organoaxial Gastric Volvulus
Mesenteroaxial Gastric Volvulus
Combined Gastric Volvulus
Most Common Pediatric Presentation • Child <5 years old • Nonbilious emesis • Epigastric distention • Abdominal pain
Acute vs Chronic
Diagnosis and Treatment • Definitive diagnosis- upper GI • Definitive therapy- repair of associated defects and anterior fixation of the stomach to the abdominal wall • Surgical repair- mortality rate 5% • Simple reduction • Open or laparoscopic gastropexies • Gastrostomy-tube placements • Fundoplications
Mortality Rates • Acute volvulus- 7% • Chronic volvulus- 3% • Nonsurgical chronic volvulus management- 0.8%
References • Cribbs RK, Gow KW, and Wulkan ML. Gastric volvulus in infants and children. Pediatrics. 2008; 122:752-762.
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Symptoms Acute gastric volvulus may be associated (up to 70% of cases) with Borchardt's Triad, which consists of: Abdominal pain; Retching without vomiting
Pediatric Gastric Volvulus: Diagnostic and Clinical Approach Federica Porcaroa Girolamo Mattiolib Claudio Romanoa aPediatric Department, University of ...
Gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach of more than 180°, creating a closed-loop obstruction ...
Gastric volvulus in infants and children. ... An electronic literature search was performed to find all published cases of pediatric gastric volvulus.
1. Arch Surg. 1991 Sep;126(9):1146-9. Gastric volvulus in the pediatric population. Miller DL(1), Pasquale MD, Seneca RP, Hodin E. Author information ...
Gastric volvulus is a significant, rare cause of non-bilious vomiting and consists of a pathological rotation of the stomach of more than 180° around the ...
Gastric volvulus in children Alexandre Darani, Mario Mendoza-Sagaon, Olivier Reinberg* Department of Pediatric Surgery, University Hospital of Lausanne ...
Gastric Volvulus in Infants and Children ... seen in pediatric patients with gastric volvulus to further our understanding of this rare and complex condition.
Malrotation and Midgut Volvulus . ... The role of radionuclide studies in pediatric ... Detection of ectopic gastric mucosa in Meckel's ...
Gastric Volvulus Clinical Presentation. ... Hodin E. Gastric volvulus in the pediatric population. Arch Surg. 1991 Sep. 126(9):1146-9. .