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‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus
Background: Gastric volvulus (GV) is a life-threatening emergency condition that prompts emergent surgical management. With the advent of high-resolution computed tomography (CT), the role of radiologists in its diagnosis has become essential. Although many cases of GV have been described in the lit...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878744/ https://www.ncbi.nlm.nih.gov/pubmed/35202185 http://dx.doi.org/10.3390/tomography8010019 |
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author | Láinez Ramos-Bossini, Antonio Jesús Ruiz Carazo, Eduardo Rabadán Caravaca, María Dolores |
author_facet | Láinez Ramos-Bossini, Antonio Jesús Ruiz Carazo, Eduardo Rabadán Caravaca, María Dolores |
author_sort | Láinez Ramos-Bossini, Antonio Jesús |
collection | PubMed |
description | Background: Gastric volvulus (GV) is a life-threatening emergency condition that prompts emergent surgical management. With the advent of high-resolution computed tomography (CT), the role of radiologists in its diagnosis has become essential. Although many cases of GV have been described in the literature, its pathophysiology is still poorly understood. In addition, there is substantial terminological confusion with associated entities such as paraesophageal hernia, upside-down stomach, organo-axial or chronic GV. Methods: We conducted a retrospective review of clinical, radiological findings and other relevant data for seven patients with previous radiological diagnoses of a large hiatus hernia who presented with acute GV to the emergency department of our institution. We report data on age, sex, medical history, clinical presentation, imaging, treatment and outcomes for each case. Results: The CT findings at acute presentation showed the antrum lying above the diaphragm and dilated fundus below the diaphragm. By comparing the position of the stomach at acute presentation with previous imaging examinations, we confirmed a hypothesis put forward by a few authors decades ago that re-herniation of the gastric fundus into the abdomen is a common pathophysiologic trigger leading to acute GV. This hypothesis has not been supported by modern imaging examinations. Conclusions: We have provided imaging evidence supporting that the pathophysiology of many GVs is based on caudal re-descent of hiatal hernia into the abdominal cavity. Given the terminological disparity used in the literature in this context, we believe it appropriate to introduce and extend the term ‘back-and-forth stomach’ to refer to this type of GV. |
format | Online Article Text |
id | pubmed-8878744 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88787442022-02-26 ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus Láinez Ramos-Bossini, Antonio Jesús Ruiz Carazo, Eduardo Rabadán Caravaca, María Dolores Tomography Article Background: Gastric volvulus (GV) is a life-threatening emergency condition that prompts emergent surgical management. With the advent of high-resolution computed tomography (CT), the role of radiologists in its diagnosis has become essential. Although many cases of GV have been described in the literature, its pathophysiology is still poorly understood. In addition, there is substantial terminological confusion with associated entities such as paraesophageal hernia, upside-down stomach, organo-axial or chronic GV. Methods: We conducted a retrospective review of clinical, radiological findings and other relevant data for seven patients with previous radiological diagnoses of a large hiatus hernia who presented with acute GV to the emergency department of our institution. We report data on age, sex, medical history, clinical presentation, imaging, treatment and outcomes for each case. Results: The CT findings at acute presentation showed the antrum lying above the diaphragm and dilated fundus below the diaphragm. By comparing the position of the stomach at acute presentation with previous imaging examinations, we confirmed a hypothesis put forward by a few authors decades ago that re-herniation of the gastric fundus into the abdomen is a common pathophysiologic trigger leading to acute GV. This hypothesis has not been supported by modern imaging examinations. Conclusions: We have provided imaging evidence supporting that the pathophysiology of many GVs is based on caudal re-descent of hiatal hernia into the abdominal cavity. Given the terminological disparity used in the literature in this context, we believe it appropriate to introduce and extend the term ‘back-and-forth stomach’ to refer to this type of GV. MDPI 2022-01-21 /pmc/articles/PMC8878744/ /pubmed/35202185 http://dx.doi.org/10.3390/tomography8010019 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Láinez Ramos-Bossini, Antonio Jesús Ruiz Carazo, Eduardo Rabadán Caravaca, María Dolores ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus |
title | ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus |
title_full | ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus |
title_fullStr | ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus |
title_full_unstemmed | ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus |
title_short | ‘Back-and-Forth Stomach’ CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus |
title_sort | ‘back-and-forth stomach’ ct imaging findings of a pathophysiologic entity causing acute gastric volvulus |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878744/ https://www.ncbi.nlm.nih.gov/pubmed/35202185 http://dx.doi.org/10.3390/tomography8010019 |
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