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Gastric torsion: Not such a rare entity
M F Omojola1, K K Patil, J K Iyengar
1Departments of Medicine and Surgery, College of Medicine, King Saud University, and Department of Surgery, Asir Central Hospital, Abha, Saudi Arabia.
Annals of Saudi Medicine
|March 1, 1991
Summary
Chronic gastric torsion, a rare condition causing persistent stomach pain and vomiting, requires a high index of suspicion for accurate diagnosis. Early recognition through upper gastrointestinal series is crucial for effective management in both children and adults.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Chronic gastric torsion is a rare but serious condition affecting both pediatric and adult populations.
- Symptoms can be non-specific, leading to diagnostic delays.
Purpose of the Study:
- To describe the clinical presentation, diagnostic methods, and management of chronic gastric torsion.
- To emphasize the importance of recognizing this condition in patients with recurrent abdominal symptoms.
Main Methods:
- Retrospective case series of seven patients diagnosed with chronic gastric torsion over 28 months.
- Diagnostic confirmation using upper gastrointestinal series.
- Surgical management strategies were reviewed.
Main Results:
- Four pediatric patients (three infants) and three adult patients were identified.
- Infants presented with projectile vomiting and failure to thrive; adults with epigastric pain and vomiting.
- Upper gastrointestinal series was diagnostic in all cases, though classic radiographic signs can be subtle.
Conclusions:
- A high index of suspicion is necessary for diagnosing chronic gastric torsion, especially in infants with unexplained vomiting and failure to thrive, and adults with recurrent abdominal pain.
- Upper gastrointestinal series is a key diagnostic tool, ideally performed during symptomatic episodes in adults.
- Surgical intervention is the definitive management, with varied associated anomalies observed in pediatric cases.
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