[A case of acute gastric volvulus in a newborn infant]

Gastric volvulus is a rare cause of respiratory distress and vomiting in neonates. This diagnosis was suspected in a 4 week old baby with acute respiratory distress accompanied with vomiting, from the results of an esophagogastroduodenal radiological examination. At operation a gastric volvulus was confirmed, associated with an anatomical malformation: absence of gastrosplenic omentum predisposing to gastric volvulus with mesenterio-axial rotation. Gastropexy was followed by an uncomplicated postoperative course. A literature review confirmed rarity of this affection and raised the problem of causes of repeated vomiting in the newborn and premature infant. An often incriminated lesion is gastric plicature, a radiological notion, whereas gastric volvulus is accompanied necessarily by an altered uptake of contrast in the stomach. Acute volvulus must be distinguished from other types of volvulus, notably that observed during hiatus hernia. Early diagnosis allows rapid surgical treatment by anterior gastropexy as recommended by most authors.