Acute gastric volvulus: diagnosis and management over 10 years.
OBJECTIVE
Gastric volvulus is a rare, potentially life-threatening condition, which is difficult to diagnose. This study represents a series of patients with acute gastric volvulus.


METHODS
All patients presenting with acute gastric volvulus over a 10-year period were reviewed.


RESULTS
Twenty-one patients with a median age of 66 years were identified. Acute gastric volvulus was secondary to a paraesophageal hiatus hernia in 16 patients. The major symptoms were abdominal pain, vomiting and upper gastrointestinal bleeding/anemia. The most useful investigations were barium studies and upper gastrointestinal endoscopy. Treatment was open surgery in all patients. There were no major complications and no deaths. Median hospitalization was 8 days.


CONCLUSIONS
Acute gastric volvulus is a rare condition which requires a high index of suspicion for diagnosis, which is usually based on imaging studies. The treatment is immediate surgery. Volvulus can be treated successfully by open surgery with minimal morbidity and short hospitalization.
Gourgiotis
Stavros
S
First Surgical Department, Evangelismos General Hospital, Athens, Greece. drsgourgiotis@tiscali.co.uk
Vougas
Vasilis
V
Germanos
Stylianos
S
Baratsis
Sotiris
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013277:Stomach Volvulus / Q000175:diagnosis* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome