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Gastric necrosis following a hiatal hernia: A case report

INTRODUCTION: Gastric volvulus are rare. Complications can be life threatening, including necrosis and perforation. Assessment of mucosal viability is essential, and urgent surgical intervention is mandatory in case of vascular compromise. PRESENTATION OF CASE: An 72-year-old female known for a para...

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Detalles Bibliográficos
Autores principales: Longchamp, Gregoire, Andres, Axel, Abbassi, Ziad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810906/
https://www.ncbi.nlm.nih.gov/pubmed/33453464
http://dx.doi.org/10.1016/j.ijscr.2020.12.092
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author Longchamp, Gregoire
Andres, Axel
Abbassi, Ziad
author_facet Longchamp, Gregoire
Andres, Axel
Abbassi, Ziad
author_sort Longchamp, Gregoire
collection PubMed
description INTRODUCTION: Gastric volvulus are rare. Complications can be life threatening, including necrosis and perforation. Assessment of mucosal viability is essential, and urgent surgical intervention is mandatory in case of vascular compromise. PRESENTATION OF CASE: An 72-year-old female known for a paraesophageal hiatal hernia was admitted at our emergency department with acute abdominal pain. Blood count demonstrated leukocytosis and increased C-reactive protein. Abdominal computed tomography showed a mesenteroaxial gastric volvulus. Urgent upper endoscopy revealed mucosal ischemia, which prompted immediate laparotomy with partial gastrectomy, cruroplasty, and Dor fundoplication. Postoperative course was uneventful. DISCUSSION: Gastric volvulus is initially treated with nasogastric tube decompression, but definitive treatment is achieved surgically. When there is an associated hernia, closing the anatomical defect and fundoplication should be performed. Complication such as necrosis is associated with a high mortality, and requires urgent surgical repair. CONCLUSION: Gastric volvulus can be life-threatening. Urgent endoscopic or surgical assessment should be conducted to assess mucosal viability.
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spelling pubmed-78109062021-01-22 Gastric necrosis following a hiatal hernia: A case report Longchamp, Gregoire Andres, Axel Abbassi, Ziad Int J Surg Case Rep Case Report INTRODUCTION: Gastric volvulus are rare. Complications can be life threatening, including necrosis and perforation. Assessment of mucosal viability is essential, and urgent surgical intervention is mandatory in case of vascular compromise. PRESENTATION OF CASE: An 72-year-old female known for a paraesophageal hiatal hernia was admitted at our emergency department with acute abdominal pain. Blood count demonstrated leukocytosis and increased C-reactive protein. Abdominal computed tomography showed a mesenteroaxial gastric volvulus. Urgent upper endoscopy revealed mucosal ischemia, which prompted immediate laparotomy with partial gastrectomy, cruroplasty, and Dor fundoplication. Postoperative course was uneventful. DISCUSSION: Gastric volvulus is initially treated with nasogastric tube decompression, but definitive treatment is achieved surgically. When there is an associated hernia, closing the anatomical defect and fundoplication should be performed. Complication such as necrosis is associated with a high mortality, and requires urgent surgical repair. CONCLUSION: Gastric volvulus can be life-threatening. Urgent endoscopic or surgical assessment should be conducted to assess mucosal viability. Elsevier 2021-01-06 /pmc/articles/PMC7810906/ /pubmed/33453464 http://dx.doi.org/10.1016/j.ijscr.2020.12.092 Text en © 2021 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Longchamp, Gregoire
Andres, Axel
Abbassi, Ziad
Gastric necrosis following a hiatal hernia: A case report
title Gastric necrosis following a hiatal hernia: A case report
title_full Gastric necrosis following a hiatal hernia: A case report
title_fullStr Gastric necrosis following a hiatal hernia: A case report
title_full_unstemmed Gastric necrosis following a hiatal hernia: A case report
title_short Gastric necrosis following a hiatal hernia: A case report
title_sort gastric necrosis following a hiatal hernia: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810906/
https://www.ncbi.nlm.nih.gov/pubmed/33453464
http://dx.doi.org/10.1016/j.ijscr.2020.12.092
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