Pediatric Gastric Volvulus

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Information about Pediatric Gastric Volvulus
Health & Medicine

Published on April 8, 2014

Author: dpark419

Source: slideshare.net

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

Anatomy Review

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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