[12 cases of chronic stomach volvulus treated by Kapandji's gastro-omphalopexy].
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The case of an 11-year-old girl with a history of chondrodysplasia punctata is reported. She presented with a clinical picture of abdominal pain and vomiting. At surgical intervention an organo-axial gastric volvulus was found and a single derotation was performed. Three weeks after discharge the patient presented abdominal distension and vomiting. In a plain abdominal X-ray film a gastric dilation was appreciated and a new volvulus was detected by means of a contrast radiogram. The diagnosis was confirmed at surgery and a gastropexy was performed without volvulus relapse.
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A 72-year-old woman had been experiencing upper abdominal pain and vomiting for 2 years. On physical examination the abdomen was swollen and pressure sensitive. She had a leukocytosis (11,400/microliter) and hypokalaemia (3.6 mmol/l). X-ray films of the chest and abdomen revealed a large gastric air-bubble with two fluid levels of different height and an elevated left diaphragm, findings which suggested gastric volvulus. Most of the fluid was evacuated via a nasogastric tube. The stomach interior was difficult to examine by gastroscopy: it was only after withdrawal of the gastroscope from the duodenum that a normal gastric architecture was demonstrated, the volvulus apparently having been reduced during the gastroscopy. The gastric mucosa showed ulcerations and erosions. Gastropexy by gluing together the peritoneal layers was undertaken via dual percutaneous endoscopic gastrostomy. The catheters were removed after 4 weeks when the ulcerations had healed. The patient has been free of symptoms for more than a year so far.
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In this article, the radiographic examination and presentation of dogs with gastric dilatation-volvulus syndrome is discussed. Much emphasis is placed on the influence of gravitational positioning on the detection of the abnormality. A list of radiographic signs is included.
The authors report about one observation of acute gastric volvulus on paraoesophageal hiatus hernia caused by a choledocholithiasis, requiring gastrectomy and choledochotomy in emergency. On the basis of this case they sum up the main characteristics of this complication of hiatus hernia and insist on a earlier diagnosis before stage of irreversible lesions.
Volvulus of the stomach. On occasion of three observations the volvulus of the stomach is studied in the light of recent advances of the literature. Different types of gastric volvulus are defined by etiopathogenic analysis. Symptomatology and diagnosis are examined and possibilities of treatment are emphasized. The therapeutic behaviour which is required towards this rare affection is discussed.
Volvulus of the stomach is a rare condition, but when acute it requires prompt diagnosis and treatment. Chronic volvulus occurs more frequently and does not always require treatment. Certain predisposing factors, such as abnormalities of the diaphragm, ulcers, or neoplasms, may be present.
The management of a patient in whom both organoaxial volvulus of the stomach and volvulus of the sigmoid colon had occurred is described. Anterior gastropexy was successful in preventing recurrence of the gastric volvulus. The angulation and distortion of the stomach so produced may have been responsible for the development of a benign gastric ulcer.
In experienced hands, the value of the laparoscopic Nissen fundoplication as antireflux correction is established. The case report concerns a woman who underwent an emergency laparotomy for acute intrathoracic stomach volvulus with incarceration, one year after a laparoscopic Nissen fundoplication was carried out without closure of the diaphragmatic hiatus. In literature acute postoperative paraoesophageal hernia with intrathoracic migration of the stomach as an early and late complication of the laparoscopic fundoplication has already been reported. The authors advocate the closure of the diaphragmatic crura as a routine manoeuvre during the laparoscopic fundoplication.
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