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Volvulus of stomach in childhood
H Chatterjee1, S Jagdish, K S Rao
1Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry.
Insights
This study reports on six infants with gastric volvulus, a condition causing vomiting. Surgical interventions were successful, with no deaths, highlighting effective treatment for this rare pediatric condition.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Neonatal Care
Background:
- Gastric volvulus is a rare but serious condition in infants.
- Vomiting and regurgitation are primary symptoms, often leading to diagnostic delays.
- Associated congenital anomalies, such as eventration of the diaphragm, can complicate diagnosis and management.
Purpose of the Study:
- To report on the clinical presentation, diagnosis, and surgical management of gastric volvulus in infants.
- To evaluate the outcomes of different surgical approaches in this pediatric population.
- To highlight the importance of prompt diagnosis and appropriate surgical intervention.
Main Methods:
- Retrospective review of six pediatric cases with gastric volvulus.
- Diagnostic confirmation using barium meal studies.
- Surgical interventions performed via abdominal approach, including diaphragm plication, colonic displacement, and gastrostomy.
- Follow-up for complications and reoperations.
Main Results:
- Six infants under one year of age presented with gastric volvulus.
- Common symptoms included vomiting and regurgitation of feeds.
- Four cases had concurrent eventration of the left hemidiaphragm.
- Surgical management involved various procedures with no operative mortality.
- One case required reoperation for a missed Ladd's band.
Conclusions:
- Gastric volvulus in infants, though rare, requires prompt diagnosis and surgical management.
- Abdominal surgical approaches are effective in treating pediatric gastric volvulus.
- Associated anomalies like diaphragmatic eventration necessitate careful surgical planning.
- Early recognition and treatment can lead to favorable outcomes, even with potential complications.
Abstract:
Six children, aged upto one year, with volvulus of the stomach are reported. Vomiting and regurgitation of feeds were the main presenting symptoms. Eventration of the left hemidiaphragm was present in four cases. Barium meal confirmed the diagnosis. Five cases were operated on through an abdominal approach. Plication of the diaphragm (3 cases), colonic displacement (2) and gastrostomy (3) were resorted to. One child needed reoperation for a missed Ladd's band. There was no operative mortality.