Gastric volvulus
| Classification according to ICD-10 | |
|---|---|
| K31.8 | Other specified diseases of the stomach and duodenum |
| ICD-10 online (WHO version 2019) | |
A gastric volvulus , lat .: volvulus ulcer is an abnormal rotation ( volvulus ) of the stomach with the pinch Magenein- or outlet is.
Epidemiology / spread
A gastric volvulus usually occurs with a hiatal hernia , relaxation of the diaphragm , less often with changes in position due to diseases of the stomach or adjacent organs, for example tumors or adhesions. Pronounced overinflation of the intestine can also be the cause of incomplete or intermittent stomach torsion. A combination with rotation of the transverse colon is possible.
Acute volvulus is considered a rare disease in newborns and infants. Acute volvulus can occur as a complication after fundoplication .
Pathogenesis / Disease Development
The organ is twisted in a spiral either around its longitudinal axis or across it.
Clinical manifestations
Acute volvulus
With a complete volvulus, the stomach cannot empty itself either upwards or downwards, so that the picture of an ileus emerges with increasing inflation of the stomach. It is no longer possible for food to pass through the esophagus into the stomach. Complications include necrosis of the stomach wall, perforation, or air embolism in the portal vein circulation.
Chronic volvulus
In the case of an incomplete rotation, the obstruction of passage and thus the clinical symptoms are not so pronounced, so that chronic courses with delayed diagnosis can occur.
diagnosis
If the occlusion is complete, feeding a nasogastric tube is not possible. Together with epigastric meteorism and vomiting, there is what is known as the Borchardt triad, named after the Berlin surgeon Moritz Borchardt (1868–1948).
In the sonography an abnormal position of is pyloric an important note. The X-ray image while standing / hanging shows an air-filled stomach and different levels of secretion with an otherwise air-poor intestine. A contrast agent administration confirms the passage stop.
therapy
The treatment takes place surgically with fixation of the stomach in neutral position. In the intermittent form, endoscopic and percutaneous procedures are promising.
literature
- HG Peitz: [Volvulus in childhood]. In: The Radiologist. Vol. 37, No. 6, June 1997, pp. 439-445, ISSN 0033-832X . doi: 10.1007 / s001170050236 . PMID 9340672 . (Review).
- BW Tillman, NH Merritt, H. Emmerton-Coughlin, S. Mehrotra, T. Zwiep, R. Lim: Acute gastric volvulus in a six-year-old: a case report and review of the literature. In: The Journal of emergency medicine. Vol. 46, No. 2, February 2014, pp. 191-196, ISSN 0736-4679 . doi: 10.1016 / j.jemermed.2013.08.046 . PMID 24144613 . (Review).
Individual evidence
- ^ W. Pschyrembel: Clinical dictionary. Verlag Walter de Gruyter, 265th edition (2014) ISBN 3-11-018534-2
- ↑ W. Schuster, D. Färber (editor): Children's radiology. Imaging diagnostics. Springer 1996, ISBN 3-540-60224-0 , page 457
- ^ J. Reyes-Zamorano: [Acute gastric volvulus: late complication of Nissen fundoplication. Report of two cases and review of the literature]. In: Cirugia y cirujanos. Vol. 82, No. 5, 2014 Sep-Oct, pp. 541-540, ISSN 0009-7411 . PMID 25259434 .
- ^ Borchardt triad
- ↑ FJ Altenwerth: Treatment of an intermittent gastric volvulus by gastropexy using percutaneous endoscopic gastrostomy. In: German Medical Weekly (1946). Vol. 119, No. 48, December 1994, pp. 1658-1660, ISSN 0012-0472 . doi: 10.1055 / s-2008-1058884 . PMID 7988366 .
