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Zuiki T, Hosoya Y, Lefor AK, Tanaka H, Komatsubara T, Miyahara Y, Sanada Y, Ohki J, Sekiguchi C, Sata N. The management of gastric volvulus in elderly patients. Int J Surg Case Rep 2016; 29:88-93. [PMID: 27835806 PMCID: PMC5107685 DOI: 10.1016/j.ijscr.2016.10.058] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 12/31/2022] Open
Abstract
Endoscopy is necessary for management of gastric volvulus. Endoscopic reduction is effective as first aid for gastric volvulus. Endoscopic gastropexy is available for gastric volvulus in elderly patients. Laparoscopic gastropexy can be an alternative to hernia repair in poor condition.
Introduction Gastric volvulus is torsion of the stomach and requires immediate treatment. The optimal treatment strategy for patients with gastric volvulus is not established, because of significant variations in the cause and clinical course of this condition. Presentation of cases We describe our experience with six elderly patients with gastric volvulus caused by different conditions using various approaches. This includes two patients managed with endoscopic reduction, followed by endoscopic or laparoscopic gastropexy. Discussion Endoscopy is a necessary first step to determine the optimal treatment strategy, and endoscopic reduction is often effective. The indications for surgical repair of gastric volvulus depend on the patient’s overall condition, and several options are available. In some elderly patients with severe comorbidities, major surgery may have an unacceptably high risk. We propose a novel treatment strategy for gastric volvulus in the elderly and a review of the literature. Conclusion Early endoscopy is necessary in patients with gastric volvulus. Endoscopic or laparoscopic gastropexy may be adequate therapy in selected elderly patients.
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Affiliation(s)
- Toru Zuiki
- Department of Surgery, Yuki Hospital, Yuki 9629-1, Yuki City, Ibaraki, Japan.
| | - Yoshinori Hosoya
- Department of Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Koganei Chuo Hospital, Koganei 2-4-3, Shimotsuke City, Tochigi, Japan
| | | | - Yuzo Miyahara
- Department of Surgery, Yuki Hospital, Yuki 9629-1, Yuki City, Ibaraki, Japan
| | - Yukihiro Sanada
- Department of Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan
| | - Jun Ohki
- Department of Surgery, Yuki Hospital, Yuki 9629-1, Yuki City, Ibaraki, Japan
| | - Chuji Sekiguchi
- Department of Surgery, Nasu Minami Hospital, Chuo 3-2-13, Nasukarasuyama City, Tochigi, Japan
| | - Naohiro Sata
- Department of Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke City, Tochigi, Japan
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Arima K, Hashimoto D, Takata N, Doi Y, Yoshinaka I, Harada K, Baba H. Acute gastric volvulus in a patient with trisomy 21. Surg Case Rep 2016; 1:5. [PMID: 26943373 PMCID: PMC4747932 DOI: 10.1186/s40792-014-0005-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/24/2014] [Indexed: 11/10/2022] Open
Abstract
Acute gastric volvulus is a torsion of the stomach by more than 180° and a life-threatening condition. We present a 50-year-old male patient with acute abdominal pain who has Down syndrome/trisomy 21. Computed tomography showed a significant distended stomach with features of a severe gastric volvulus. Emergency operation in form of reduction and gastropexy was performed. We are not aware of any similar cases published in the English literature, where as gastric volvulus occurred in a patient with Down syndrome.
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Affiliation(s)
- Kota Arima
- Department of Surgery, Amakusa Regional Medical Center, 854-1 Jikiba, Kameba-machi, Amakusa, Kumamoto, 863-0046, Japan. .,Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Daisuke Hashimoto
- Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Noboru Takata
- Department of Surgery, Amakusa Regional Medical Center, 854-1 Jikiba, Kameba-machi, Amakusa, Kumamoto, 863-0046, Japan.
| | - Yasuro Doi
- Department of Surgery, Amakusa Regional Medical Center, 854-1 Jikiba, Kameba-machi, Amakusa, Kumamoto, 863-0046, Japan.
| | - Ichiro Yoshinaka
- Department of Surgery, Amakusa Regional Medical Center, 854-1 Jikiba, Kameba-machi, Amakusa, Kumamoto, 863-0046, Japan.
| | - Kazunori Harada
- Department of Surgery, Amakusa Regional Medical Center, 854-1 Jikiba, Kameba-machi, Amakusa, Kumamoto, 863-0046, Japan.
| | - Hideo Baba
- Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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Farber BA, Lim IIP, Murphy JM, Price AP, Abramson SJ, La Quaglia MP. Gastric Volvulus Following Left Pneumonectomy in an Adolescent Patient. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2015; 3:447-450. [PMID: 26504742 DOI: 10.1016/j.epsc.2015.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gastric volvulus is a rare post-pneumonectomy complication. Although it has been described previously, published cases are limited to an older patient population. We report the youngest case of postpneumonectomy gastric volvulus to date, occurring in an 18-year-old male with a history of inflammatory myofibroblastic pseudotumor who underwent left intrapericardial pneumonectomy, and presented 13 years later with chronic intermittent mesenteroaxial gastric volvulus. While postpneumonectomy gastric volvulus is a rare occurrence, it should remain in the differential diagnosis in postoperative thoracic surgical patients presenting with chest pain.
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Affiliation(s)
- Benjamin A Farber
- Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Irene Isabel P Lim
- Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jennifer M Murphy
- Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Anita P Price
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sara J Abramson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael P La Quaglia
- Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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Ksia A, Haggui B, Mosbahi S, Maazoun K, Sahnoun L, Chahed J, Krichene I, Mekki M, Belghith M, Nouri A. [Gastric volvulus in children: five case reports]. Arch Pediatr 2014; 21:1339-43. [PMID: 25449446 DOI: 10.1016/j.arcped.2014.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 05/26/2014] [Accepted: 09/21/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED 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.
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Affiliation(s)
- A Ksia
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie.
| | - B Haggui
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - S Mosbahi
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - K Maazoun
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - L Sahnoun
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - J Chahed
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - I Krichene
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - M Mekki
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - M Belghith
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - A Nouri
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
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Ndour O, Wissem M, Ndoye NA, Ngom G. Acute gastric volvulus and wandering spleen: A rare association. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
INTRODUCTION Gastric volvulus is an important cause of nonbilious emesis that must be recognized early to ensure a good outcome. We reviewed 7 cases from our institution, Children's Healthcare of Atlanta (Egleston campus). In addition, we reviewed all gastric volvulus cases in children published to date in the English literature to draw general conclusions about the presentation and treatment of this unusual disease. METHODS An electronic literature search was performed to find all published cases of pediatric gastric volvulus. The care of all children from January 2002 to December 2007 who were treated for gastric volvulus was also reviewed. RESULTS There have been 581 cases of gastric volvulus in children published in English between 1929 and 2007. Of these, 252 were acute and 329 were chronic cases. The most common presentation of acute gastric volvulus is in a child <5 years old with nonbilious emesis, epigastric distention, and abdominal pain. Acute gastric volvulus is often associated with deformities of adjacent organs. Definitive diagnosis is made with upper gastrointestinal studies, and definitive therapy requires repair of associated defects and anterior fixation of the stomach to the abdominal wall. The most common presentation of chronic volvulus is in an infant <1 year old with emesis, epigastric distention, feeding difficulties, and growth failure. Treatment may be medical or surgical depending on the underlying etiology of the volvulus. CONCLUSIONS Acute gastric volvulus is a potentially life-threatening occurrence with a good outcome when treated in a timely fashion. Chronic volvulus may be more difficult to recognize. The common features of acute and chronic gastric volvulus described in this review should assist pediatric health care providers in promptly diagnosing and treating this disease.
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Affiliation(s)
- Randolph Kyle Cribbs
- Emory University, Division of Pediatric Surgery, 2015 Uppergate Dr NE, Atlanta, GA 30322, USA
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Komuro H, Matoba K, Kaneko M. Laparoscopic gastropexy for chronic gastric volvulus complicated by pathologic aerophagia in a boy. Pediatr Int 2005; 47:701-3. [PMID: 16354230 DOI: 10.1111/j.1442-200x.2005.02128.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hiroaki Komuro
- Department of Pediatric Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Abstract
Gastric volvulus is a rare cause of acute abdomen in children. Usually it is associated with defects such as diaphragmatic hernia, hiatal hernia, eventration, and paralysis of the diaphragm. We report an extremely rare case presenting with acute intractable vomiting and abdominal distention. Passage of a nasogastric tube relieved the symptoms. A history of the ingestion of a large bolus of chewing gum and a suboptimal contrast study were misleading, and there was a delay in diagnosis of 3 days. Later, repeat upper GI fluoroscopy with contrast medium identified mesenteroaxial volvulus of the stomach. Exploratory laparotomy additionally revealed a wandering spleen. Derotation of the stomach with anterior gastropexy was performed. To our knowledge, wandering spleen in association with gastric volvulus has been mentioned only three times before in the literature.
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Affiliation(s)
- Abid Qazi
- Department of Surgery, P.O. Box 100, North West Armed Forces Hospital (NWAFH), Tabuk, Saudi Arabia.
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Naim HJ, Smith R, Gorecki PJ. Emergent laparoscopic reduction of acute gastric volvulus with anterior gastropexy. Surg Laparosc Endosc Percutan Tech 2004; 13:389-91. [PMID: 14712102 DOI: 10.1097/00129689-200312000-00009] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Gastric volvulus is characterized by abnormal rotation of the stomach around an axis made by two fixed portions. Symptoms of gastric volvulus range from anemia and weight loss to severe epigastric or chest pain associated with nonproductive vomiting or upper gastrointestinal bleeding. Ischemia, necrosis, and perforation will occur if this condition remains untreated. We report a case of a 92-year-old patient with acute gastric volvulus treated with laparoscopic reduction and anterior gastropexy. We suggest that the laparoscopic approach to gastric volvulus is safe and feasible and should be considered. High-risk and elderly patients can particularly benefit from minimally invasive access. Anterior gastropexy palliates the symptoms and can be considered a definitive treatment in this patient population.
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Affiliation(s)
- H Joseph Naim
- Department of Surgery, New York Methodist Hospital, Brooklyn 11215, USA
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Schleef J, von Bismarck S. An easy method for laparoscopic-assisted percutaneous anterior gastropexy. Surg Endosc 2000; 14:964-5. [PMID: 11080413 DOI: 10.1007/s004640000202] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Laparoscopic antireflux surgery is becoming a standard procedure in pediatric surgery. Anterior gastropexy is often performed in antireflux procedures, as well as in children with recurrent and intermittent volvulus of the stomach. We present a simple and secure technique for anterior laparoscopic-assisted gastropexy.
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Affiliation(s)
- J Schleef
- Clinic of Pediatric Surgery, University of Graz Medical School, Auenbruggerplatz 34, A - 8036 Graz, Austria
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