title: Gastric volvulus in children--a diagnostic problem: two case reports.
abstract: BACKGROUND
  Gastric volvulus is a clinically significant cause of acute or recurrent abdominal pain and chronic vomiting in children. Since related clinical symptoms are nonspecific, clinicians often refer to radiologists for a diagnostic evaluation. Early diagnosis is crucial to prevent life-threatening complications of prolonged volvulus, such as intestinal ischemia, infarction, strangulation, necrosis, and perforation that may require immediate surgical treatment. In this report, we describe clinical and radiological criteria for diagnosis of gastric volvulus in children.
  
  
  METHODS
  We describe two pediatric clinical cases. A 16-month-old female Caucasian child was admitted to our hospital for recurrent postprandial vomiting episodes, which started at 11 months old, associated with failure to thrive. A 9-month-old term-born baby boy was admitted for chronic, recurrent, postprandial vomiting, which started at 7 months of age, with progressive failure to thrive. A barium study allowed definitive diagnosis of chronic organoaxial gastric volvulus.
  
  
  CONCLUSIONS
  Gastric volvulus is an extremely rare disorder in the pediatric population. It can be considered a complex clinical condition with regard to the etiology and the management. A nonoperative approach is advisable in the absence of warning signs.
authors.affiliation: Radiology Department, University of Messina, Policlinico G. Martino, Gazzi, Messina, 98100, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Trecroci
authors.affiliation: Pediatric Department, University of Messina, Via Consolare Valeria 1, 98125, Messina, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Morabito
authors.affiliation: Pediatric Department, University of Messina, Via Consolare Valeria 1, 98125, Messina, Italy. romanoc@unime.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Romano
authors.affiliation: Radiology Department, University of Messina, Policlinico G. Martino, Gazzi, Messina, 98100, Italy.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Salamone
mesh_terms: D001466:Barium Sulfate; D003287:Contrast Media; D005183:Failure to Thrive / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019518:Postprandial Period; D011859:Radiography; D013270:Stomach / Q000000981:diagnostic imaging*; D013277:Stomach Volvulus / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000209:etiology
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
keywords: Computed tomography; Gastric volvulus; Pediatrics; Radiography; Vomiting