Related Experiment Videos
Chronic gastric volvulus and hypertrophic pyloric stenosis in an infant
Athina Anagnostara1, Chrissoula Koumanidou, Marina Vakaki
1Department of Radiology, "Agia Sophia" Children's Hospital, Thivon and Mikras Asias, 11527 Goudi, Athens, Greece.
Insights
A rare case of chronic secondary mesenteroaxial gastric volvulus in an infant, initially mimicking hypertrophic pyloric stenosis, highlights the importance of considering gastric volvulus in pediatric vomiting diagnoses.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging in Pediatrics
- Surgical Case Reports
Background:
- Chronic secondary mesenteroaxial gastric volvulus is infrequently documented, especially in pediatric cases.
- Hypertrophic pyloric stenosis is a common cause of infant vomiting, often overshadowing other diagnoses.
Observation:
- A 2-month-old infant presented with gastric distension and projectile vomiting, symptoms suggestive of hypertrophic pyloric stenosis.
- Diagnostic imaging, including sonography, chest radiography, and upper GI series, revealed mesenteroaxial gastric volvulus and diaphragmatic eventration.
Findings:
- The infant was diagnosed with chronic secondary mesenteroaxial gastric volvulus, a rare condition.
- Surgical intervention led to a successful recovery with no post-operative abnormalities noted on follow-up sonography.
Implications:
- This case underscores the necessity of including gastric volvulus (primary or secondary) in the differential diagnosis for pediatric vomiting.
- Accurate and timely diagnosis through appropriate imaging modalities is crucial for effective management of pediatric gastric volvulus.
Abstract:
Chronic secondary mesenteroaxial gastric volvulus associated with hypertrophic pyloric stenosis has rarely been mentioned in the general medical literature. We report the case of a 2-month-old boy whose clinical symptoms, which included distension of the stomach and projectile vomiting, suggested the diagnosis of hypertrophic pyloric stenosis but who was later diagnosed with chronic secondary mesenteroaxial gastric volvulus. Sonographic examination revealed findings consistent with a rotated stomach, and subsequent plain chest radiography demonstrated a left diaphragmatic eventration. An upper gastrointestinal series radiographic examination with barium contrast enhancement confirmed the diagnosis of mesenteroaxial gastric volvulus. Surgery was performed, and the boy recovered well. A follow-up sonographic examination performed 3 months post-operatively revealed no abnormalities. This case demonstrates that primary or secondary gastric volvulus, although rare in children, should be considered in the differential diagnosis of pediatric patients with a history of vomiting.