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Gastric volvulus in children: our experience.
Bilal Mirza1, Lubna Ijaz, Afzal Sheikh
1Department of Pediatric Surgery, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan. blmirza@yahoo.com
Summary
Pediatric gastric volvulus is rare, often linked to diaphragmatic defects. Correcting these underlying issues is sufficient for managing secondary gastric volvulus in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Gastric volvulus is an exceptionally rare condition in children, presenting complex etiological and management challenges.
- Understanding the specific factors contributing to gastric volvulus in pediatric patients is crucial for effective treatment.
Purpose of the Study:
- To investigate the causes, clinical presentation, treatment strategies, and outcomes of gastric volvulus in pediatric patients.
- To identify the predisposing factors and types of gastric volvulus in the pediatric population.
Main Methods:
- A retrospective review of 10 pediatric patients diagnosed with gastric volvulus between May 2006 and October 2010.
- Analysis of patient records, including clinical history, physical examination findings, diagnostic imaging, operative details, and patient outcomes.
Main Results:
- Seven of the 10 patients were male, with a mean age of 2.87 years at presentation.
- Half of the patients exhibited the classic Borchardt triad; radiological investigations were key to diagnosis in most cases.
- Secondary gastric volvulus, associated with diaphragmatic defects (eventration, hernias, traumatic rupture), was more common (70%) than primary gastric volvulus (30%). Organoaxial volvulus was observed in seven patients, and mesenterioaxial in three.
Conclusions:
- Diaphragmatic defects are significant contributors to secondary gastric volvulus in children.
- While the Borchardt triad is present in 50% of cases, presentation can be variable.
- Correcting the predisposing anatomical defects, particularly diaphragmatic issues, is an effective management strategy for secondary gastric volvulus in children, often without the need for gastropexy.
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