Gastric volvulus in children.
OBJECTIVE
The aim of the study was to review the records of all children who presented with gastric volvulus in the past 10 years.


METHODS
The study group consisted of 21 children with an age range from 0.2 months to 4.3 years who were operated for gastric volvulus from 1992 to 2003.


RESULTS
Initial symptoms included acute abdominal pain after meals, vomiting, and in 8 cases, acute apnea associated with pallor, cyanosis, and hypotonia. After the first episode, barium studies revealed an organoaxial gastric volvulus in all cases. The surgical procedure was an anterior gastropexy with reinforcement of the esophagogastric angle performed by laparoscopy in 13 cases and by laparotomy in 8 (1 converted laparoscopy). An associated antireflux fundoplication was done in 3 patients. All children received postoperative antireflux medication for at least 1 month. The follow-up ranged from 4 months to 4.8 years. Two children in the laparotomy group required reoperation (Toupet fundoplication) for persistent gastroesophageal reflux disease. All children are currently symptom-free and without treatment.


CONCLUSIONS
Gastric volvulus is a clinical and radiological reality, which can be treated by a gastropexy. Initial fundoplication is not mandatory. The laparoscopic gastropexy is a good option and allows a repeat laparoscopic procedure if needed.
Darani
Alexandre
A
Department of Pediatric Surgery, University Hospital of Lausanne (CHUV), CH-1011 Lausanne-CHUV, Switzerland.
Mendoza-Sagaon
Mario
M
Reinberg
Olivier
O
D000208:Acute Disease; D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000706:statistics & numerical data; D007813:Laparotomy / Q000706:statistics & numerical data; D008297:Male; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013277:Stomach Volvulus / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*