Advertisement

Management of Acute Gastric Volvulus

  • Kathleen Simon
  • Jon GouldEmail author
Chapter

Abstract

Acute gastric volvulus is a relatively rare, but serious, surgical emergency defined as rotation of the stomach greater than 180 °. This leads to foregut luminal obstruction and compromised blood flow to the stomach with ischemia and potentially necrosis. Treatment is initiated with gastric decompression via a nasogastric tube or endoscopic decompression. Definitive surgical management includes reduction of the volvulized stomach, resection of gastric necrosis if present, and gastropexy. A high index of suspicion is necessary to ensure a prompt work-up and intervention. If diagnosis and treatment are significantly delayed, morbidity and mortality rates can be high. This is related to the fact that the cohort of patients likely to be affected by this phenomenon is typically the elderly and often frail with decreased physiologic reserve to tolerate such an insult.

Keywords

Gastric volvulus Paraesophageal hernia Hiatal hernia Organoaxial volvulus Mesenteroaxial volvulus 

References

  1. 1.
    Haas O, Rat P, Christophe M, Friedman S, Favre JP. Surgical results of intrathoracic gastric volvulus complicating hiatal hernia. Br J Surg. 1990;77(12):1379–81.CrossRefGoogle Scholar
  2. 2.
    Palanivelu C, Rangarajan M, Shetty AR, Senthilkumar R. Laparoscopic suture gastropexy for gastric volvulus: a report of 14 cases. Surg Endosc. 2007;21(6):863–6.CrossRefGoogle Scholar
  3. 3.
    Gourgiotis S, Vougas V, Germanos S, Baratsis S. Acute gastric volvulus: diagnosis and management over 10 years. Dig Surg. 2006;23(3):169–72.CrossRefGoogle Scholar
  4. 4.
    McElreath DP, Olden KW, Aduli F. Hiccups: a subtle sign in the clinical diagnosis of gastric volvulus and a review of the literature. Dig Dis Sci. 2008;53(11):3033–6.CrossRefGoogle Scholar
  5. 5.
    Larssen KS, Stimec B, Takvam JA, Ignjatovic D. Role of imaging in gastric volvulus: stepwise approach in three cases. Turk J Gastroenterol. 2012;23(4):390–3.CrossRefGoogle Scholar
  6. 6.
    Tanner NC. Chronic and recurrent volvulus of the stomach with late results of “colonic displacement”. Am J Surg. 1968;115(4):505–15.CrossRefGoogle Scholar
  7. 7.
    Rashid F, Thangarajah T, Mulvey D, Larvin M, Iftikhar SY. A review article on gastric volvulus: a challenge to diagnosis and management. Int J Surg. 2010;8(1):18–24.CrossRefGoogle Scholar
  8. 8.
    Williamson JM, Dalton RS, Mahon D. Acute giant gastric volvulus causing cardiac tamponade. J Gastrointest Surg. 2010;14(7):1199–200.CrossRefGoogle Scholar
  9. 9.
    Shivanand G, Seema S, Srivastava DN, Pande GK, Sahni P, Prasad R, et al. Gastric volvulus: acute and chronic presentation. Clin Imaging. 2003;27(4):265–8.CrossRefGoogle Scholar
  10. 10.
    Al-Balas H, Hani MB, Omari HZ. Radiological features of acute gastric volvulus in adult patients. Clin Imaging. 2010;34(5):344–7.CrossRefGoogle Scholar
  11. 11.
    Teague WJ, Ackroyd R, Watson DI, Devitt PG. Changing patterns in the management of gastric volvulus over 14 years. Br J Surg. 2000;87(3):358–61.CrossRefGoogle Scholar
  12. 12.
    Katkhouda N, Mavor E, Achanta K, Friedlander MH, Grant SW, Essani R, et al. Laparoscopic repair of chronic intrathoracic gastric volvulus. Surgery. 2000;128(5):784–90.CrossRefGoogle Scholar
  13. 13.
    Kawai M, Hiramatsu M, Lee SW, Tokuhara T, Fujita Y, Nomura E, et al. Endoscopy-assisted percutaneous anterior gastropexy for gastric volvulus: a minimally invasive technique using a special instrument. Endoscopy. 2013;45(Suppl 2 UCTN):E151–2.PubMedGoogle Scholar
  14. 14.
    Colijn AW, Kneepkens CM, Taets van Amerongen A, Ekkelkamp S. Gastric volvulus after anterior gastropexy. J Pediatr Gastroenterol Nutr. 1993;17(1):105–7.CrossRefGoogle Scholar
  15. 15.
    Wolfgang R, Lee JG. Endoscopic treatment of acute gastric volvulus causing cardiac tamponade. J Clin Gastroenterol. 2001;32(4):336–9.CrossRefGoogle Scholar
  16. 16.
    Omata J, Utsunomiya K, Kajiwara Y, Takahata R, Miyasaka N, Sugasawa H, et al. Acute gastric volvulus associated with wandering spleen in an adult treated laparoscopically after endoscopic reduction: a case report. Surg Case Rep. 2016;2(1):47. 47,016-0175-0. Epub 2016 May 24.CrossRefGoogle Scholar
  17. 17.
    Kilincalp S, Akinci H, Coban S. Successful treatment of acute gastric volvulus by emergency endoscopic reduction in a patient with cerebral palsy. Endoscopy. 2014;46(Suppl 1 UCTN):E375–6.PubMedGoogle Scholar

Copyright information

© SAGES 2019

Authors and Affiliations

  1. 1.Department of SurgeryMedical College of WisconsinMilwaukeeUSA

Personalised recommendations