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Published on: September 22, 2023
Acute gastric volvulus in a pediatric patient: A rare case report
Rehab N Khalid1, Amin Moazzam Khan2, Ravikumar Hanumaiah2
1Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA.
Insights
Acute gastric volvulus, a rare pediatric emergency, can be lethal if not diagnosed and managed promptly. Early imaging, like CT scans, is crucial for diagnosis and intervention, potentially linked to CHAMP1 mutations.
Area of Science:
- Pediatric Gastroenterology
- Surgical Emergencies
- Rare Diseases
Background:
- Acute gastric volvulus is a rare, life-threatening condition in children, involving stomach rotation.
- It can cause severe complications including ischemia, perforation, and splenic involvement.
- Prompt diagnosis and management are critical for favorable outcomes.
Abstract:
Acute gastric volvulus is an extremely rare but possibly lethal condition within the pediatric population and is defined by the abnormal rotation of the stomach that can lead to serious complications like ischemia, perforation, or splenic involvement if not promptly diagnosed and managed. We report the case of a 2-year-old male with a history of Chromosome Alignment-Maintaining Phosphoprotein 1 (CHAMP1) mutation and prior gastric ulcers who presented with hematemesis, retching, and feeding intolerance. Abdominal radiograph showed nonspecific dilation of the gastric bubble, and contrast-enhanced computed tomography (CT) confirmed mesentero-axial volvulus with splenic displacement. The patient underwent successful nasogastric decompression followed by laparotomy, gastric detorsion, and percutaneous endoscopic gastrostomy tube placement. This case emphasizes the role of early imaging, particularly CT, in diagnosing pediatric gastric volvulus and suggests a potential link between CHAMP1-associated hypotonia and volvulus. Timely recognition and intervention are essential for favorable outcomes in such rare pediatric emergencies.
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