Related Experiment Video

Updated: Jun 20, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
10:52

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh

Published on: September 11, 2021

Delayed presentation of congenital diaphragmatic hernia with intrathoracic gastric volvulus

Ramazan Karabulut1, Zafer Türkyilmaz, Kaan Sönmez

  • 1Department of Pediatric Surgery, Gazi University Medical Faculty, 06500, Ankara, Turkey. karabulutr@yahoo.com

World Journal of Pediatrics : WJP
|August 21, 2009
PubMed

Insights

Gastric volvulus (GV) is a rare but life-threatening obstruction in children. Prompt diagnosis and surgical intervention are crucial to prevent gastric necrosis and ensure favorable outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Radiology

Background:

  • Gastric volvulus (GV) is a rare upper gastrointestinal obstruction caused by abnormal stomach rotation.
  • Intrathoracic GV, particularly with delayed congenital diaphragmatic hernia, presents unique diagnostic and management challenges in infants.

Observation:

  • A 16-month-old infant presented with recurrent projectile vomiting and epigastric pain, initially resolving then recurring.
  • Physical examination revealed epigastric fullness and a palpable mass.
  • Radiological studies, including barium contrast, confirmed mesenteroaxial gastric volvulus.

Findings:

  • Laparotomy revealed non-necrotic intrathoracic gastric volvulus with an intrathoracic spleen and a large left-sided congenital diaphragmatic hernia.
  • Surgical repair involved diaphragmatic repair, gastropexy, and splenopexy.

Implications:

  • This case highlights the importance of considering intrathoracic gastric volvulus in infants with unexplained vomiting and diaphragmatic abnormalities.
  • Timely diagnosis via upper gastrointestinal studies and CT scans is critical.
  • Prompt surgical management is essential to prevent gastric ischemia and ensure patient survival.
Abstract

Related Concept Videos

Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
Pyloric Obstruction01:11

Pyloric Obstruction

Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...