The conservative approach for infantile gastric volvulus

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Neonatal Care

Background:

• Chronic gastric volvulus is a rare but serious condition in neonates.
• It is often misdiagnosed as gastroesophageal reflux disease (GERD).
• Accurate diagnosis and timely intervention are crucial for optimal outcomes.

Purpose of the Study:

• To evaluate the effectiveness of conservative management for chronic gastric volvulus in neonates.
• To analyze diagnostic and therapeutic approaches in a series of pediatric patients.
• To determine the success rate of non-surgical interventions.

Main Methods:

• Retrospective review of 13 neonates diagnosed with chronic gastric volvulus (2015-2024).
• Analysis of clinical and imaging data, including contrast-enhanced upper gastrointestinal radiography.
• Conservative treatment involved enteral feeding, positional strategies, and parenteral nutrition.

Main Results:

• Twelve out of 13 patients (92.3%) were successfully managed conservatively.
• The most frequent symptom was non-bilious vomiting.
• Mean follow-up of 30.61 months showed all patients achieved appropriate weight gain, with a 90.9% conservative management success rate.

Conclusions:

• Conservative management is a highly effective primary treatment for neonatal chronic gastric volvulus.
• Contrast-enhanced imaging is essential for accurate diagnosis, differentiating it from GERD.
• Standardized conservative protocols can significantly reduce the necessity for surgical gastropexy.