Download - Pediatric Gastric Volvulus
![Page 1: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/1.jpg)
Pediatric Gastric VolvulusRebecca Starr, D.O.
PICU Review
4/8/14
![Page 2: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/2.jpg)
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
![Page 3: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/3.jpg)
Anatomy Review
![Page 4: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/4.jpg)
Volvulus Etiology
• Ligament abnormalities
• Abnormalities of gastric anatomy or gastric function
• Abnormalities of adjacent organs • Diaphragm
• Spleen
• Transverse colon
• Intestines
• Liver
![Page 5: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/5.jpg)
Organoaxial Gastric Volvulus
![Page 6: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/6.jpg)
Mesenteroaxial Gastric Volvulus
![Page 7: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/7.jpg)
Combined Gastric Volvulus
![Page 8: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/8.jpg)
Most Common Pediatric Presentation
• Child <5 years old
• Nonbilious emesis
• Epigastric distention
• Abdominal pain
![Page 9: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/9.jpg)
Acute vs Chronic
![Page 10: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/10.jpg)
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
![Page 11: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/11.jpg)
Mortality Rates
• Acute volvulus- 7%
• Chronic volvulus- 3%
• Nonsurgical chronic volvulus management- 0.8%
![Page 12: Pediatric Gastric Volvulus](https://reader036.vdocument.in/reader036/viewer/2022081420/555e4ce1d8b42a8e4c8b48c8/html5/thumbnails/12.jpg)
References
• Cribbs RK, Gow KW, and Wulkan ML. Gastric volvulus in infants and children. Pediatrics. 2008; 122:752-762.