Acute mesenteroaxial gastric volvulus and congenital diaphragmatic hernia

Abstract

The current report describes the case of an 11-year-old girl with Down syndrome who was admitted because of sudden abdominal pain and vomiting. Her symptoms were secondary to severe gastric volvulus associated with congenital diaphragmatic hernia.

Delayed presentation of congenital diaphragmatic hernia with intrathoracic gastric volvulus

“…Other predisposing factors of GV have been described in the literature, such as asplenia and wandering spleen. [5] GV was described with EhlersDanlos syndrome in mentally impaired children with chronic gastric distension and hypertrophic pyloric stenosis. [8,12] GV is classifi ed according to four criteria: rotation (mesenteroaxial, organoaxial, or mixed), degree (complete or incomplete), presentation (acute or chronic), and direction (anterior or posterior).…”

“…Many authors describe the frequent association of diaphragmatic defects with GV. [5][6][7] Congenital diaphragmatic hernia was found in 65% of children with GV and in 84% of those aged less than 1 month. [8] Bilateral eventration of the diaphragm and Morgagni hernia associated with GV have also been reported.…”

“…The principles of the surgical procedure include derotation of the volvulus, reduction of the herniated stomach, closure of the associated diaphragmatic defect and fi xation of the stomach to the anterior abdominal wall. [5,16] GV is a rare entity in pediatric surgery that should be considered in any infant with unexplained vomiting and in patients presenting with left diaphragmatic anomalies on a plain abdominal radiograph. CT scan or upper gastrointestinal study with contrast meal is suggested to detect diaphragmatic defect, intrathoracic solid and hollow organs (spleen, stomach, colon, and kidney), and torsed or volvulated structures.…”

Bockdalek Hernia With Gastric Volvulus With Ischemia in An Adult: A Case Report

“…Gastric volvulus poses a unique risk to physicians, due to their relative rarity and potentially life-threatening complications, so a high index of suspicion must be maintained when a patient presents with the classical symptoms of intractable vomiting, persistent epigastric pain, and inability/difficulty inserting a nasogastric tube [23,24]. This is the classic Bortchardt's triad.…”

Acute gastric volvulus: a case report

“…1 Complications include gastric ischemia, gangrene, perforation, pancreatic necrosis, omental avulsion and evensplenic rupture. [2][3][4] The rarity of the disease accounts for the associated high mortality (30-50%) and hence requires high index of clinical suspicion. 5 A high index of suspicion and prompt and correct diagnosis followed by immediate surgery may be the key to reduce the high morbidity and mortality.…”