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Gastric volvulus in children.

Alexandre Darani1, Mario Mendoza-Sagaon, Olivier Reinberg

  • 1Department of Pediatric Surgery, University Hospital of Lausanne (CHUV), CH-1011 Lausanne-CHUV, Switzerland.

Journal of Pediatric Surgery
|June 7, 2005
PubMed
Summary

Gastric volvulus in children is a treatable condition. Anterior gastropexy, especially laparoscopically, effectively resolves symptoms, with fundoplication not always necessary.

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Abdominal Surgery

Background:

  • Gastric volvulus is a rare but serious condition in children.
  • It involves the abnormal rotation of the stomach, potentially leading to obstruction and ischemia.

Purpose of the Study:

  • To review treatment outcomes for pediatric gastric volvulus over a 10-year period.
  • To evaluate the efficacy of surgical interventions for gastric volvulus in children.

Main Methods:

  • Retrospective review of 21 children operated for gastric volvulus (1992-2003).
  • Surgical approaches included anterior gastropexy (laparoscopic or laparotomy), with or without fundoplication.
  • Follow-up assessed symptom resolution and need for reoperation.

Main Results:

  • Common symptoms included abdominal pain, vomiting, and apnea. Organoaxial gastric volvulus was confirmed by barium studies.
  • Anterior gastropexy, particularly laparoscopic, was successful in all cases.
  • Two patients required reoperation for persistent gastroesophageal reflux disease after laparotomy.

Conclusions:

  • Gastric volvulus is a surgically manageable condition in children.
  • Anterior gastropexy is an effective treatment; initial fundoplication is not mandatory.
  • Laparoscopic gastropexy offers a minimally invasive approach with potential for repeat laparoscopic procedures if needed.

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