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KMID : 0816120000030010089
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2000 Volume.3 No. 1 p.89 ~ p.92
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A Case of Gastric Volvulus in a 3-year-old Female
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Lee Jin-Tae
Kim Han-Sun
Tchah Hann
Park Ho-jin
Kim Hwa-Jung
Kim Hee-Sup
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Abstract
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Acute gastric volvulus is uncommon but surgically emergent.
Normally, the stomach is held in position by four ligaments: gastrophrenic,
gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus
and esophagus provides further anchorage. A normal diaphragm also helps to prevent
abnormal displacement of abdominal viscera and development of gastric volvulus.
Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial
volvulus is the rotation of the stomach around an axis extending from the hiatus of the
diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around
an axis transecting the lesser and greater curvatures of the stomach. The symptoms of
gastric volvulus depend on its type, the extent and degree of rotation and obstruction,
and associated defects. Classic clinical features of acute gastric volvulus, as by
Borchardt in 1904, include unproductive retching, acute, localized epigastric distention,
and the inability to pass a NG tube. The Presence and severity of these features depend
on the degree of gastric obstruction of both the gastroesophageal junction and pyloric
outlet.
It may be suspected on plain abdominal radiographs and usually confirmed by upper
gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to
avoid recurrence, and correction of any underlying anatomic abnormality. Any associate
defect should be repaired and the stomach must be fixed.
The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric
volvulus.
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KEYWORD
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Gastric Volvulus, Child,
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