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Pediatric Gastric
Volvulus
Rebecca Starr, D.O.
PICU Review
4/8/14
What is Gastric Volvulus?
• Twisting of all or a portion of the stomach at least 180° about an axis that causes an
obstruc...
Anatomy Review
Volvulus Etiology
• Ligament abnormalities
• Abnormalities of gastric anatomy or gastric function
• Abnormalities of adjac...
Organoaxial Gastric Volvulus
Mesenteroaxial Gastric Volvulus
Combined Gastric Volvulus
Most Common Pediatric Presentation
• Child <5 years old
• Nonbilious emesis
• Epigastric distention
• Abdominal pain
Acute vs Chronic
Diagnosis and Treatment
• Definitive diagnosis- upper GI
• Definitive therapy- repair of associated defects and anterior f...
Mortality Rates
• Acute volvulus- 7%
• Chronic volvulus- 3%
• Nonsurgical chronic volvulus management- 0.8%
References
• Cribbs RK, Gow KW, and Wulkan ML. Gastric volvulus in infants and
children. Pediatrics. 2008; 122:752-762.
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Pediatric Gastric Volvulus

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Transcript of "Pediatric Gastric Volvulus"

  1. 1. Pediatric Gastric Volvulus Rebecca Starr, D.O. PICU Review 4/8/14
  2. 2. What is Gastric Volvulus? • Twisting of all or a portion of the stomach at least 180° about an axis that causes an obstruction of the foregut • Rare in children • Acute, intermittent, recurrent, or chronic • Acute gastric volvulus • Life- threatening occurrence • Good outcome when treated quickly • Chronic volvulus may be more difficult to recognize
  3. 3. Anatomy Review
  4. 4. Volvulus Etiology • Ligament abnormalities • Abnormalities of gastric anatomy or gastric function • Abnormalities of adjacent organs • Diaphragm • Spleen • Transverse colon • Intestines • Liver
  5. 5. Organoaxial Gastric Volvulus
  6. 6. Mesenteroaxial Gastric Volvulus
  7. 7. Combined Gastric Volvulus
  8. 8. Most Common Pediatric Presentation • Child <5 years old • Nonbilious emesis • Epigastric distention • Abdominal pain
  9. 9. Acute vs Chronic
  10. 10. Diagnosis and Treatment • Definitive diagnosis- upper GI • Definitive therapy- repair of associated defects and anterior fixation of the stomach to the abdominal wall • Surgical repair- mortality rate 5% • Simple reduction • Open or laparoscopic gastropexies • Gastrostomy-tube placements • Fundoplications
  11. 11. Mortality Rates • Acute volvulus- 7% • Chronic volvulus- 3% • Nonsurgical chronic volvulus management- 0.8%
  12. 12. References • Cribbs RK, Gow KW, and Wulkan ML. Gastric volvulus in infants and children. Pediatrics. 2008; 122:752-762.
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