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[Chronic idiopathic gastric volvulus in children]
L Canazza1, E Bianchini, M Cerri
1Istituti Clinici di Perfezionamento, Ospedale dei Bambini V. Buzzi, UO di Chirurgia Pediatrica, Via Castelvetro 32, 20154 Milano, Italia. chirpedbuzzi@tiscali.it
Summary
Chronic idiopathic volvulus, a gastric condition, may not always require surgery. Conservative treatments are effective for some patients, while others may need surgical intervention if symptoms persist or recur.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Context:
- Chronic idiopathic volvulus is a rare condition involving the abnormal rotation of the stomach.
- Diagnosis can be challenging, especially with atypical symptoms mimicking gastroesophageal reflux disease.
Purpose:
- To present clinical, radiographic, and instrumental data on 18 cases of gastric chronic idiopathic volvulus.
- To evaluate the efficacy of conservative versus surgical management for this condition.
Summary:
- 18 patients with gastric chronic idiopathic volvulus were diagnosed via barium meal or pHmetric esophageal monitoring.
- Conservative treatment (antireflux positioning and prokinetics) was initiated, with 5 patients recovering after one year.
- 13 patients required surgery due to lack of improvement or relapse during conservative therapy.
Impact:
- Abnormal gastric position alone is not an absolute indication for surgery.
- Surgical intervention should be considered when conservative medical management fails to alleviate symptoms or when relapse occurs.