Gastric volvulus occurs when the stomach rotates about its longitudinal axis (organo-axial volvulus), or about an axis joining the lesser and greater curvatures (mesentero-axial volvulus). Primary gastric volvulus, making up one third of cases, occurs when the stabilizing ligaments are too lax as a result of congenital or acquired causes. Secondary gastric volvulus, making up the remainder of cases, occurs in association with a paraesophageal hernia or other congenital or acquired diaphragmatic defects. While gastric volvulus may occur acutely, especially in children, it may not be clinically apparent and discovered incidentally. The authors present a case of chronic organo-axial volvulus of the stomach secondary to left hemidiaphragmatic eventration with a review of the relevant literature.
BACKGROUND: The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture.METHODS: Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39?69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2?14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer.RESULTS: There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment.CONCLUSIONS: Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.
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