Gastric Volvulus: Report of Six Cases
摘要
Gastric volvulus is a rare condition existing to the gastroenterologist today. We reviewed six cases of gastric volvulus in our hospital between 1993 and 1997. Of these six cases, five had bouts of severe epigastric pain, four patients had unproducting vomiting, and two patients had UGI bleeding. Only one case was found incidentally without any volvulus-related symptoms. Peptic ulcer disease and UGI bleeding were the common initial presumptive impressions. In none of the patients was the condition clinically suspected. In type of gastric volvulus, two patients were mesenteroaxial and four were organoaxial. In the study of predisposing factors, paraesophageal hernia, previous surgery of stomach, an age of over 65 years, and gastric ulcer were noted. In treatment, surgical intervention for 2 cases with acute gastric volvulus achieved good results. Three chronic cases sustained occasional bouts of epigastralgia, varying in severity. Two of them had no symptoms during the follow-up period after naso gastric tube decompression and medical treatment. One patient sustained vague epigastric pain with evidence of gastric volvulus within 12 months of follow-up. In conclusion, gastric volvulus must be considered in the differential diagnosis of acute abdomen or other vague GI complaints as its presentation may be subtle. An understanding of the varied clinical features and predisposing factors is essential to early recognition, and adequate treatment selection includes emergent surgery.