Gastric volvulus in childhood

doi:10.1016/S0022-3468(87)80596-1

Journal of Pediatric Surgery

Volume 22, Issue 10, October 1987, Pages 944-947

https://doi.org/10.1016/S0022-3468(87)80596-1 Get rights and content

Gastric volvulus is a rare surgical emergency in infancy and childhood. Only 51 cases have been reported. We describe four new cases. The classical features of the condition are discussed.

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Cited by (60)

Acute gastric volvulus six years after PEG-tube placement
2022, Journal of Pediatric Surgery Case Reports
Citation Excerpt :
Gastric volvulus(GV) is a rare condition, especially in children [1].
Gastric volvulus (GV) is a rare condition in children, occurring either acute or chronically, usually requiring surgical treatment. It results from increased gastric mobility due to absent or attenuated gastric ligaments. Known associations exist with diaphragmatic eventration, diaphragmatic hernia, hiatal hernia and asplenia. Cases of GV following gastrostomy are extremely rare; we report the 6th case world-wide. Our patient, an eleven year old girl with cerebral palsy, presented with a fulminant GV and pneumoperitoneum. She underwent emergency laparotomy revealing gastric necrosis and a large perforation. After closing the defect, we performed a scheduled relaparotomy four days later, and resected the remaining clearly marked necrosis, leaving a considerably smaller stomach, but preventing a gastrectomy. With this report, we would like to draw attention to this life-threatening condition and possible complication of gastrostomies.
Gastric volvulus in children: Five case reports
2014, Archives de Pediatrie
Le volvulus gastrique est une rotation anormale d’une partie ou de tout l’estomac sur l’un de ses axes. C’est une cause rare d’obstruction digestive chez l’enfant. Cette affection est le plus souvent primitive, favorisée par un défaut des ligaments de fixation gastrique. Elle peut aussi être secondaire à d’autres malformations congénitales. Nous rapportons cinq cas de cette affection colligés entre janvier 1994 et décembre 2011 chez 4 garçons et une fille avec un âge moyen de 7 mois. Le diagnostic s’est appuyé sur la clinique et surtout le transit œsogastro-duédénal qui confirmait le diagnostic. Quatre parmi les 5 enfants ont été opérés par voie laparoscopique avec fixation de l’estomac. Une hernie diaphragmatique était associée dans un cas. Un geste antireflux a été réalisé dans trois cas, et la fermeture du défect diaphragmatique dans un cas. Les suites ont été simples dans tous les cas, avec un recul moyen de 7 ans. La bonne connaissance de cette maladie est garante d’un diagnostic précoce et d’une prise en charge rapide permettant d’améliorer le pronostic.
Gastric volvulus is an abnormal rotation of all or a part of the stomach around one of its axes. It is a rare cause of intestinal obstruction in children. This anomaly can be primary, due to abnormalities of the gastric ligaments, or secondary to other congenital malformations. We report on the cases of five children treated between January 1994 and December 2011, four boys and one girl, with a medium age of 7 months. Diagnosis was based on clinical features, particularly in the upper gastrointestinal Rx contrast study, which confirmed the diagnosis. Four out of the five children underwent laparoscopic surgery with fixation of the stomach. A diaphragmatic hernia was associated in one case. Antireflux surgery was performed in three cases, and a diaphragmatic defect was closed in one case. The follow-up was uneventful after a medium period of 7 years. Conclusion: good knowledge of this anomaly is the guarantee of early diagnosis and optimum treatment to ameliorate the prognosis.
Gastric volvulus: A rare association with hyperamylasemia
2013, Journal of Pediatric Surgery Case Reports
Citation Excerpt :
She remained well on follow-up at three years. Gastric volvulus was first described by Berti in 1866 [3,4]. It could have acute, chronic or acute on chronic presentation.
We wish to report two rare and potentially fatal cases of acute gastric volvulus in children associated with hyperamylasemia. Plain films, CT scan, contrast studies and upper gastrointestinal endoscopy were helpful in confirming the diagnosis. They underwent emergency laparotomy with devolvulus and temporary gastrostomy in the first case and posterior gastropexy in association with plication of eventrated left hemi-diaphragm with good recovery.
Volvulus of the Stomach and Small Bowel
2012, Shackelford's Surgery of the Alimentary Tract: Volume 1-2, Seventh Edition
Gastric volvulus in children: lessons learned from delayed diagnoses
2009, Seminars in Pediatric Surgery
Citation Excerpt :
This is referred to as the Borchardt triad. This triad has been noted by other authors to be of little value in children.19,20 In contradistinction to adults, children with both acute and chronic volvulus presented much more commonly with productive retching (nonbilious emesis) in 75% and 71% of the patients, respectively.
Gastric volvulus in infants, children, and adolescents is a rare event. The purpose of this study is to examine this congenital abnormality and its consequences, using cases with significant adverse outcomes. We will specifically discuss issues of diagnosis and treatment of acute gastric volvulus in association with diaphragmatic anomalies. In addition, the different types of gastric volvulus are compared and contrasted, highlighting areas that may allow for early recognition and prevention of complications related to this foregut obstructive process. Three clinical cases are reviewed, all with significant morbidity and/or mortality. These cases are combined with larger case series to arrive at a list of relatively specific clinical and radiologic findings that can alert the clinician to this diagnosis and thus expedite the child's assessment and treatment, averting major complications.
Of snakes and babies: intrathoracic stomach and vertebral rachischisis. A serpentine-like syndrome?
2008, Journal of Pediatric Surgery
Citation Excerpt :
When you factor in the lack of rib malformations in either of the cases, it makes this an unlikely presentation of this syndrome. Total intrathoracic stomach has been reported sporadically, with the stomach in a state of volvulus in most reported cases [6-10]. Petersons et al [11] reported 2 cases of total intrathoracic stomach in infants with Marfan's syndrome.
Snakes have intrathoracic stomachs and rachischisis-like spinal vertebrae. These anomalies are rare in babies and have not been previously described in combination in the English medical literature. Here we present 2 cases of total intrathoracic stomach with a foreshortened esophagus, cervical spine rachischisis, and splenic anomalies in newborns. Both had 46, XX karyotypes. The first case was initially treated with mobilization of the stomach into the abdomen. However, at 18 months the stomach was found to have retracted back into the thorax. Subsequently, the patient received a Collis gastroplasty and G-tube. Two-year follow-up is available. The second case exhibited the abovementioned anomalies along with absence of toes 3 and 4 on the right foot, and cardiac anomalies not compatible with life. The parents chose to withdraw support. The encountered abnormalities may be explained by a first trimester mesenchymal insult and share some similarities with the VACTERL association. In our experience, mobilization of the stomach into the abdomen without elongation of the esophagus will fail. If tolerated, the management of the intrathoracic stomach should include preoperative intragastric feedings to allow time for gastric enlargement followed by a Collis gastroplasty. The management of cervical rachischisis requires assessment of cervical spine stability and cervical immobilization. As other life-threatening birth defects may be present, thorough evaluation should be completed before counseling the families of the treatment options available.

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¹: From King's College Hospital, London.

View full text

Gastric volvulus in childhood

Am J Surg

J Pediatr Surg

Volvulus of the stomach. A review with a report of 8 cases

Br J Surg

Gastric volvulus in the newborn

Arch Surg