Cases reported "Stomach Volvulus"

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1/28. Gastric volvulus associated with wandering spleen in a child.

    wandering spleen is an uncommon entity in childhood and has been described only rarely in association with gastric volvulus. wandering spleen and gastric volvulus were diagnosed in a 5-year-old boy who presented with acute abdominal pain and distension. Intraoperatively, normal ligamentous connections between the stomach, spleen, and posterior abdominal wall were absent. Developmental anomalies that result in wandering spleen may lead to hypermobility of the stomach and a predisposition to gastric volvulus. In such patients, prophylactic gastropexy should be considered.
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2/28. Neonatal gastric volvulus.

    Three infants with acute gastric volvulus occurring during the first week of life are presented, bringing the total number of cases reported in the neonatal period to nine. Abdominal radiographs and constrast studies of the upper gastrointestinal tract were nearly identical in all three infants and showed a characteristic pattern that allowed unequivocal preoperative diagnosis. It is essential that the radiologist recognize the radiographic features of acute gastric volvulus, since prompt operative intervention is mandatory to prevent late complications, which include gastric perforation and death.
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3/28. Laparoscopic repair of gastric volvulus.

    BACKGROUND AND OBJECTIVES: Acute and chronic gastric volvulus usually present with different symptoms and affect patients primarily after the fourth decade of life. Volvulus can be diagnosed by an upper gastrointestinal contrast study or by esophagogastroduodenoscopy. There are three types of gastric volvulus: 1) organoaxial (most common type); 2) mesenteroaxial; and 3) a combination of the two. If undetected or if a delay in diagnosis and treatment occurs, serious complications can develop. methods: We present four cases of surgical repair of organoaxial volvulus consisting of laparoscopic reduction of the volvulus with excision of the hernia sac and reapproximation of the diaphragmatic crura. A Nissen fundoplication, to prevent reflux, was performed, and the stomach was pexed to the anterior abdominal wall by laparoscopic placement of a gastrostomy tube, thus preventing recurrent volvulus. RESULTS: There were no operative complications, and all four patients tolerated the procedure well. The patients were discharged one to three days postoperatively and were asymptomatic within two months. CONCLUSION: With the advancement of laparoscopic Nissen fundoplication and laparoscopic repair of paraesophageal and hiatal hernias, minimally invasive surgical repair is possible. Based on our experience, we advocate the laparoscopic technique to repair gastric volvulus.
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4/28. Herniation through triple defects of the diaphragm with gastric volvulus.

    A rare case of herniation through triple defects in the diaphragm with volvulus of the stomach is reported. Herniation with gastric volvulus was diagnosed preoperatively. Three diaphragmatic defects were detected at surgery. Repair of the defects after reduction of the abdominal contents resulted in an uneventful recovery.
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5/28. Volvulus of the stomach in childhood: the spectrum of the disease.

    INTRODUCTION: During a 5-year time frame, five cases of symptomatic gastric volvulus were diagnosed and treated in our department. Four presented with the acute form of gastric volvulus and underwent emergency surgery. The fifth suffered the chronic variant of the syndrome and was benefited by nonoperative management. The cases serve to remind emergency physicians of the spectrum of gastric volvulus. The report supplements the sparse clinical description in the emergency literature. RESULTS: In the operated patients, there were no postoperative complications. The outcome, to the time of publication, has been good in every instance. The history, etiology, presentation, and treatment of the disease are discussed in detail. CONCLUSIONS: Not infrequently, gastric volvulus in children fails to exhibit the full gamut of signs and symptoms such as abdominal distension, vomiting, pain, and retching. For this, as well as for other stated reasons, symptomatic gastric volvulus in infancy and childhood may not be as rare as is commonly assumed.
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6/28. Infants with radiologic diagnosis of gastric volvulus: are they over-treated?

    Gastric volvulus (GV) is a rare condition in infants. The aim of this study was to define the management strategies of infants with GV based on their clinical and radiologic features. The medical records of 13 infants with a radiologically confirmed diagnosis of GV were retrospectively reviewed. patients were divided into two groups according to the type of treatment (surgical vs conservative). Abdominal radiographs and upper gastrointestinal contrast studies allowed an unequivocal diagnosis in both groups. Group 1 included 3 infants with acute GV and 2 with chronic, intermittent secondary GV. Three patients had associated diaphragmatic defects, 1 had an ileocolic intussusception, and 1 had hypertrophic pyloric stenosis. The main presenting symptoms were vomiting, dehydration, respiratory distress, and abdominal pain and distention in acute cases and vomiting and failure to thrive in chronic cases. A laparotomy was required in all 5 infants with no recurrence of symptoms. Group 2 included 8 infants with idiopathic chronic GV, who were managed nonoperatively with gradual improvement of symptoms over 12 months. Based on our study, we conclude that: (1) laparotomy can be reserved for patients with either acute or chronic secondary GV; (2) conservative treatment is both safe and effective in infants with chronic idiopathic GV; and (3) routine gastropexy for all patients with a radiologic diagnosis of GV appears to be overtreatment.
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7/28. Acute gastric volvulus related to adhesions after laparoscopic fundoplication.

    Laparoscopic antireflux procedures currently are considered to be as safe, cost efficient, and effective as the techniques used previously in antireflux surgery, although life-threatening complications after antireflux surgery have been reported with both open and laparoscopic fundoplication. We report the case of a 38-year-old man who presented with acute abdominal pain and vomiting 8 months after a laparoscopic Nissen-Rosetti fundoplication. The diagnosis of gastric volvulus was suspected. The endoscopic examination showed a proper location of the fundoplication and features consistent with early gastric ischemia. Rotational maneuvers failed to untwist the volvulus. Emergency surgery was performed, involving a conventional laparotomy. At surgery, the volvulus was found related to a thick adhesion between the opening of the xiphoidal cannula and the hilus hepatis. The section of the adhesion allowed immediate untwisting of the volvulus. Despite a general assumption that laparoscopic procedures will reduce the incidence of postoperative adhesion formation, it should be kept in mind that laparoscopic techniques do not preclude the deposit of unusual foreign microbodies, which is an admitted mechanism of adhesion formation.
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8/28. Acute gastric volvulus due to deficiency of the gastrocolic ligament in a newborn.

    Gastric volvulus is rare in the neonatal period. Only three cases of gastric volvulus due to deficiency of gastrocolic ligament have been reported until now in the literature. We describe a neonatal case due to absence of the gastrocolic ligament. Stamm gastrostomy was performed for fixation and there has been no recurrence of his symptoms during a 13-month post-operative period. CONCLUSION: Stamm gastrostomy is a viable treatment of gastric volvulus due to lack of the gastrocolic ligament.
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9/28. Laparoscopic reduction of an acute gastric volvulus and repair of a hernia of Bochdalek.

    We report a case of an acute strangulated gastric volvulus in a hernia of Bochdalek in an adult female patient that was repaired successfully via the laparoscopic approach. A left-sided diaphragmatic hernia contained a strangulated but viable gastric volvulus and a noncompromised colon. The contents of the hernia were reduced, and the 4-cm congenital diaphragmatic defect was primarily repaired with nonabsorbable sutures. The patient was discharged on the second postoperative day and remained symptom-free at 7 months. Unlike the very few previous reports of elective laparoscopic repair of uncomplicated Bochdalek hernias, this appears to be the first report of an urgent laparoscopic repair of a complicated hernia of this type.
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10/28. Rare chronic gastric volvulus associated with left atrial and mediastinal compression.

    We report a case of chronic gastric volvulus associated with left atrial compression in a 75-year-old woman who presented with chest pain, shortness of breath, and hypotension after elective hemiarthroplasty of the left hip. The patient's medical history included a paraesophageal hernia and gastric volvulus diagnosed in 1997 but left untreated. The present diagnosis of gastric volvulus was made on the basis of a chest radiograph and subsequent computed tomography. echocardiography showed the volvulus compressing the left atrium. Surgery to repair the defect was successful, and there were no operative or postoperative complications. A review of the world medical literature revealed that gastric volvulus is rarely reported to cause hemodynamic compromise or compression of the heart and mediastinal structures.
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