Related Experiment Videos
Gastric volvulus: more common than previously thought?
1Division of Radiology, College of Medicine, King Saud University, Abha, Saudi Arabia.
Insights
Chronic and recurrent gastric volvulus is often missed, with diagnosis frequently delayed until a barium study. Awareness and suspicion are key for diagnosing this rare condition in both children and adults.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Diagnostic Imaging
Background:
- Gastric volvulus is a rare condition involving the twisting of the stomach.
- It can present with varied and often non-specific symptoms, leading to diagnostic challenges.
Observation:
- A retrospective review identified 13 cases of chronic and recurrent gastric volvulus between 1987 and 1991.
- Six cases were in pediatric patients and seven in adults.
- The condition was not clinically suspected in any patient, with diagnosis made via upper gastrointestinal (UGI) barium series.
Findings:
- Pediatric patients typically exhibited projectile vomiting and failure to thrive.
- Adults presented with dyspepsia, abdominal pain, and vomiting, mimicking other upper abdominal pathologies.
- All identified cases were organo-axial gastric volvulus, with associated conditions including hiatus hernia, small bowel malrotation, and jejunal obstruction.
Implications:
- Gastric volvulus may be more common than previously believed.
- Early diagnosis relies on heightened clinical awareness and suspicion.
- A meticulously performed UGI barium series is crucial for accurate diagnosis, especially during symptomatic episodes.
Abstract:
Over a four year period, from August 1987 to July 1991, thirteen cases of chronic and recurrent gastric volvulus were encountered comprising six paediatric and seven adult patients. In none of the patients was the condition clinically suspected; diagnosis being made only at meticulous upper gastro-intestinal (UGI) barium series. The paediatric patients typically presented with obstructive symptoms of projectile vomiting especially after meals and failure to thrive. The adults had variable symptoms of dyspepsia, recurrent intermittent upper abdominal discomfort or pain, occasionally accompanied by vomiting or retching mimicking many different upper abdominal conditions, such as peptic ulcer, biliary tract or pancreatic disease but with negative findings at endoscopy and abdominal ultrasound scanning. All cases were organo-axial type of gastric volvulus. Associated conditions were small sliding hiatus hernia in two adult cases; partial small bowel malrotation in two cases, high jejunal obstruction also in two cases and congenital hip dislocation in one patient. An infant had umbilical hernia, previous meconium cyst and meconium peritonitis. The condition seems not as uncommon as previously thought; the key to diagnosis being constant awareness, a high index of clinical suspicion and a carefully performed UGI barium series especially during the attack of pain.