title: [Recurrent gastric volvulus resolved surgically after therapeutic percutaneous endoscopic gastrostomy in Duchenne muscular dystrophy].
abstract: A 20-year-old man with Duchenne muscular dystrophy (DMD) with recurrent gastric volvulus underwent percutaneous endoscopic gastrostomy (PEG). Four months later, he developed vomiting and consciousness disturbance. CT revealed gastric volvulus recurrence along the gastrostomy axis. Endoscopic repositioning failed and fistula perforation necessitated emergency surgery. The upper position of the stomach was twisted counter-clockwise and revolved on the gastrostomy axis sliding between the lower stomach and abdominal wall. The fistula showed necrotic perforation and was thus resected. The anterior stomach wall was fixed to the abdominal wall at 3 triangular points. Thereafter, gastric volvulus did not recur. PEG is reportedly effective for preventing gastric volvulus, but there are rare cases of postgastrostomy recurrence. This successfully managed case provides valuable clinical insights.
authors.affiliation: Department of Surgery, Kiryu Kosei Hospital, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hiramatsu
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iida
authors.forename: Teruki
authors.initials: T
authors.lastname: Inoue
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yasuoka
authors.forename: Akiko
authors.initials: A
authors.lastname: Koja
authors.forename: Shuichi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Takashi
authors.initials: T
authors.lastname: Hiromatsu
mesh_terms: D004630:Emergencies; D005773:Gastroscopy; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications*; D012008:Recurrence; D013277:Stomach Volvulus / Q000601:surgery*; D055815:Young Adult