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Acute Organoaxial gastric volvulus: A massive problem with a twist-case report

INTRODUCTION: Gastric volvulus (GV) is a rare and life threatening condition if not treated promptly or wrongly diagnosed. The main complication of gastric volvulus is foregut obstruction. The extreme rotation can cut off blood supply to the stomach and even distal organs, which can lead to ischemia...

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Autores principales: Al Daoud, Fadi, Daswani., Gul Sachwani, Perinjelil, Vinu, Nigam, Tina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709345/
https://www.ncbi.nlm.nih.gov/pubmed/29156231
http://dx.doi.org/10.1016/j.ijscr.2017.11.016
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author Al Daoud, Fadi
Daswani., Gul Sachwani
Perinjelil, Vinu
Nigam, Tina
author_facet Al Daoud, Fadi
Daswani., Gul Sachwani
Perinjelil, Vinu
Nigam, Tina
author_sort Al Daoud, Fadi
collection PubMed
description INTRODUCTION: Gastric volvulus (GV) is a rare and life threatening condition if not treated promptly or wrongly diagnosed. The main complication of gastric volvulus is foregut obstruction. The extreme rotation can cut off blood supply to the stomach and even distal organs, which can lead to ischemia and necrosis of the affected area. PRESENTATION OF CASE: We report a case of a 41yo female that complained of severe abdominal pain, nausea and vomiting for approximately 3 days after eating a large meal. The patient didn’t have any flatus or bowel movements in the last 24 h. CT of the abdomen and pelvis showed a dilatation of the stomach and esophageal hernia. Laparotomy confirmed an organoaxial volvulus at the level of the antrum and body of the stomach. Gastropexy was implemented and the stomach fixed to the posterior abdominal wall to prevent recurrence. DISCUSSION: GV may have a significant related morbidity and mortality rate. It can be missed easily on diagnosis. The presence of vomiting not responding to initial antiemetic treatment, as well as, the presence of a hiatal hernia on the imaging studies should trigger our thinking of gastric volvulus, regardless of the stable appearance of the patient. CONCLUSION: Chronic GV can manifests as atypical chest, abdomen and gastro intestinal symptoms. We recommend that everyone with these atypical symptoms seek medical attention to rule out GV. Early diagnosis and treatment will reduce the risk of developing chronic gastric volvulus to acute gastric volvulus.
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spelling pubmed-57093452017-12-04 Acute Organoaxial gastric volvulus: A massive problem with a twist-case report Al Daoud, Fadi Daswani., Gul Sachwani Perinjelil, Vinu Nigam, Tina Int J Surg Case Rep Article INTRODUCTION: Gastric volvulus (GV) is a rare and life threatening condition if not treated promptly or wrongly diagnosed. The main complication of gastric volvulus is foregut obstruction. The extreme rotation can cut off blood supply to the stomach and even distal organs, which can lead to ischemia and necrosis of the affected area. PRESENTATION OF CASE: We report a case of a 41yo female that complained of severe abdominal pain, nausea and vomiting for approximately 3 days after eating a large meal. The patient didn’t have any flatus or bowel movements in the last 24 h. CT of the abdomen and pelvis showed a dilatation of the stomach and esophageal hernia. Laparotomy confirmed an organoaxial volvulus at the level of the antrum and body of the stomach. Gastropexy was implemented and the stomach fixed to the posterior abdominal wall to prevent recurrence. DISCUSSION: GV may have a significant related morbidity and mortality rate. It can be missed easily on diagnosis. The presence of vomiting not responding to initial antiemetic treatment, as well as, the presence of a hiatal hernia on the imaging studies should trigger our thinking of gastric volvulus, regardless of the stable appearance of the patient. CONCLUSION: Chronic GV can manifests as atypical chest, abdomen and gastro intestinal symptoms. We recommend that everyone with these atypical symptoms seek medical attention to rule out GV. Early diagnosis and treatment will reduce the risk of developing chronic gastric volvulus to acute gastric volvulus. Elsevier 2017-11-13 /pmc/articles/PMC5709345/ /pubmed/29156231 http://dx.doi.org/10.1016/j.ijscr.2017.11.016 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Al Daoud, Fadi
Daswani., Gul Sachwani
Perinjelil, Vinu
Nigam, Tina
Acute Organoaxial gastric volvulus: A massive problem with a twist-case report
title Acute Organoaxial gastric volvulus: A massive problem with a twist-case report
title_full Acute Organoaxial gastric volvulus: A massive problem with a twist-case report
title_fullStr Acute Organoaxial gastric volvulus: A massive problem with a twist-case report
title_full_unstemmed Acute Organoaxial gastric volvulus: A massive problem with a twist-case report
title_short Acute Organoaxial gastric volvulus: A massive problem with a twist-case report
title_sort acute organoaxial gastric volvulus: a massive problem with a twist-case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709345/
https://www.ncbi.nlm.nih.gov/pubmed/29156231
http://dx.doi.org/10.1016/j.ijscr.2017.11.016
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