How serious is gastric volvulus?
The nonoperative mortality for gastric volvulus is reportedly as high as 80%. Historically, mortality figures in the range of 30-50% have been reported for acute gastric volvulus, with the major cause of death being strangulation, which can lead to necrosis and perforation.
How is gastric volvulus treated?
With chronic gastric volvulus, surgery is performed to prevent complications. The principles associated with the treatment of gastric volvulus include decompression, reduction, and prevention of recurrence, which are best accomplished with surgical therapy.
Is a gastric volvulus a bowel obstruction?
Clinical Manifestations and Diagnosis The presentation of acute gastric volvulus includes sudden severe pain in the upper abdomen or lower chest and persistent but unproductive vomiting. Because the volvulus causes gastric obstruction, it is often impossible to pass a nasogastric tube into the stomach.
What causes stomach volvulus?
In adults, causes of a sigmoid volvulus include: an enlarged colon. abdominal adhesions that develop after surgery, injury, or infection. diseases of the large intestine, such as Hirschsprung’s disease.
How is gastric volvulus diagnosis?
The most common cause of gastric volvulus is hiatal hernia, but the principal predisposing factor is ligamentous laxity. The diagnosis is suspected when erect chest radiograph images show a high air-fluid level in the chest. Moreover a barium swallow is essential to confirm the diagnosis.
How is gastric volvulus diagnosed?
What does gastric volvulus feel like?
Typical symptoms of chronic gastric volvulus are vague and nonspecific and may include abdominal pain, vomiting, and dysphagia. Additional symptoms include heartburn and regurgitation.
Is a paraesophageal hernia serious?
A paraesophageal hernia is more dangerous. Your esophagus and stomach stay where they should be, but part of your stomach squeezes through the hiatus to sit next to your esophagus. Your stomach can become squeezed and lose its blood supply. Your doctor might call this a strangulated hernia.
How do you prevent gastric volvulus?
Manual reduction of the volvulus to relieve gastric obstruction is straightforward; however, without fixation of the stomach in its normal unobstructed orientation, recurrence of volvulus is almost guaranteed. There are two main options for prevention of recurrent volvulus: gastropexy and PEH repair.
Can humans have a twisted stomach?
Gastric volvulus or volvulus of stomach is a twisting of all or part of the stomach by more than 180 degrees with obstruction of the flow of material through the stomach, variable loss of blood supply and possible tissue death.
What is a para-esophageal hernia?
Para-esophageal hernia is a severe form of hiatal hernia that occurs in only 5% of cases. In this case we see a compound hiatal hernia, which is a combination of sliding hiatus hernia and a rolling (para-esophageal) hiatus hernia. Organo-axial gastric volvulus is the more common gastric volvulus with the stomach rotated along its long axis.
How is type III paraesophageal hernia with gastric organoaxial volvulus diagnosed?
A diagnosis of Type III paraesophageal hernia with gastric organoaxial volvulus was made based on the presentation and the results of the upper-GI series and EGD. The endoscopic diagnostic features were the twisted gastric mucosal folds, spiral luminal obstruction, and inability to pass the endoscope to the pylorus.
What is the number one cause of gastric volvulus?
Hiatal hernias are the number one cause of gastric volvulus. The incarceration of the stomach is favored by a negative intrathoracic suction pressure. Rolling hiatal hernias represent 50% of the causes of gastric volvulus in adults, unlike sliding forms which are exceptionally at the origin of this pathology [6, 10].
Can a CT scan show gastric volvulus on hiatal hernia?
The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia.