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Intrathoracic gastric volvulus: an autopsy case report

First described by Berti in 1866, gastric volvulus (GV) is an uncommon and potentially lethal entity. GV occurs when the stomach twists by more than 180º resulting in obstruction of the alimentary tract, visceral ischemia, necrosis, and perforation. It is classified according to the rotation axis in...

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Autores principales: Fetrreira, Cristiane Rúbia, Maximiano, Linda Ferreira, dos Santos, Victor Manuel Lobo, Martines, João Augusto dos Santos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: São Paulo, SP: Universidade de São Paulo, Hospital Universitário 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673687/
https://www.ncbi.nlm.nih.gov/pubmed/31528604
http://dx.doi.org/10.4322/acr.2013.014
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author Fetrreira, Cristiane Rúbia
Maximiano, Linda Ferreira
dos Santos, Victor Manuel Lobo
Martines, João Augusto dos Santos
author_facet Fetrreira, Cristiane Rúbia
Maximiano, Linda Ferreira
dos Santos, Victor Manuel Lobo
Martines, João Augusto dos Santos
author_sort Fetrreira, Cristiane Rúbia
collection PubMed
description First described by Berti in 1866, gastric volvulus (GV) is an uncommon and potentially lethal entity. GV occurs when the stomach twists by more than 180º resulting in obstruction of the alimentary tract, visceral ischemia, necrosis, and perforation. It is classified according to the rotation axis in organoaxial, mesenteroaxial or a combination of both. The clinical presentation can be acute, and is usually severe or chronic, which sometimes may be asymptomatic. It predominantly occurs in the fifth decade of life, but children, mainly those under the age of 1 year, may be affected. No ethnicity or gender was observed to show predominance. This entity is related to gastric, diaphragmatic disorders as well as laxity of gastric ligaments. Acute GV may complicate with incarceration and strangulation of the stomach when gastric necrosis ensues. These cases show a mortality rate of 60%. The authors report the fatal case of a surgically treated GV in a 43-year-old female patient who looked for medical care only after 1 month of initial symptoms. Diagnosis was confirmed with a thoracic and abdominal axial computed tomography. Besides the entire stomach being herniated and twisted into the thoracic cavity, the pancreas was pulled up through the hiatal orifice, provoking acute pancreatitis. Because of gastric necrosis and perforation, gastroenteric fluid drained into the mediastinum and left pleural space. The postoperative outcome was unfavorable resulting in the patient’s death. The authors call attention to the severeness of the disease, and therefore the need of precocity of diagnosis and surgical treatment.
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spelling pubmed-66736872019-09-16 Intrathoracic gastric volvulus: an autopsy case report Fetrreira, Cristiane Rúbia Maximiano, Linda Ferreira dos Santos, Victor Manuel Lobo Martines, João Augusto dos Santos Autops Case Rep Article / Autopsy Case Report First described by Berti in 1866, gastric volvulus (GV) is an uncommon and potentially lethal entity. GV occurs when the stomach twists by more than 180º resulting in obstruction of the alimentary tract, visceral ischemia, necrosis, and perforation. It is classified according to the rotation axis in organoaxial, mesenteroaxial or a combination of both. The clinical presentation can be acute, and is usually severe or chronic, which sometimes may be asymptomatic. It predominantly occurs in the fifth decade of life, but children, mainly those under the age of 1 year, may be affected. No ethnicity or gender was observed to show predominance. This entity is related to gastric, diaphragmatic disorders as well as laxity of gastric ligaments. Acute GV may complicate with incarceration and strangulation of the stomach when gastric necrosis ensues. These cases show a mortality rate of 60%. The authors report the fatal case of a surgically treated GV in a 43-year-old female patient who looked for medical care only after 1 month of initial symptoms. Diagnosis was confirmed with a thoracic and abdominal axial computed tomography. Besides the entire stomach being herniated and twisted into the thoracic cavity, the pancreas was pulled up through the hiatal orifice, provoking acute pancreatitis. Because of gastric necrosis and perforation, gastroenteric fluid drained into the mediastinum and left pleural space. The postoperative outcome was unfavorable resulting in the patient’s death. The authors call attention to the severeness of the disease, and therefore the need of precocity of diagnosis and surgical treatment. São Paulo, SP: Universidade de São Paulo, Hospital Universitário 2013-06-30 /pmc/articles/PMC6673687/ /pubmed/31528604 http://dx.doi.org/10.4322/acr.2013.014 Text en Autopsy and Case Reports. ISSN 2236-1960. Copyright © 2013. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the article is properly cited.
spellingShingle Article / Autopsy Case Report
Fetrreira, Cristiane Rúbia
Maximiano, Linda Ferreira
dos Santos, Victor Manuel Lobo
Martines, João Augusto dos Santos
Intrathoracic gastric volvulus: an autopsy case report
title Intrathoracic gastric volvulus: an autopsy case report
title_full Intrathoracic gastric volvulus: an autopsy case report
title_fullStr Intrathoracic gastric volvulus: an autopsy case report
title_full_unstemmed Intrathoracic gastric volvulus: an autopsy case report
title_short Intrathoracic gastric volvulus: an autopsy case report
title_sort intrathoracic gastric volvulus: an autopsy case report
topic Article / Autopsy Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673687/
https://www.ncbi.nlm.nih.gov/pubmed/31528604
http://dx.doi.org/10.4322/acr.2013.014
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