Abstract
IntroductionGastric volvulus is an uncommon clinical entity, first described by Berti in 1866. It is a rotation of all or part of the stomach through more than 180°. This rotation can occur on the longitudinal (organo-axial) or transverse (mesentero-axial) axis. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report the case of a patient with chronic intermittent gastric volvulus who underwent a successful laparoscopic treatment.Case presentationA 34-year-old woman presented with multiple episodes of recurrent upper abdominal pain associated with retching and vomiting, treated unsuccessfully with intramuscular metoclopramide. Endoscopic examination of the upper digestive tract showed a suspected rotation of the stomach, and a chronic recurrent gastric volvulus was revealed by barium meal. The patient was operated on successfully, with an anterior laparoscopic gastropexy performed as the first surgical approach.ConclusionExperience with laparoscopic anterior gastropexy is limited only to a few described cases. Our patient was clinically and radiologically followed-up for 2 years with no evidence of recurrence, either radiological or symptomatic. Based on this result, laparoscopic gastropexy can be seen and considered as an initial 'gold standard' for the treatment of gastric volvulus.
Highlights
Gastric volvulus is an uncommon clinical entity, first described by Berti in 1866
Traditional surgical therapy for gastric volvulus is based on an open approach, but the use of a laparoscopic technique is advocated for multiple pathologies that once were treated with traditional surgery
We report the case of a patient with chronic intermittent gastric volvulus who underwent a successful laparoscopic treatment
Summary
Chronic gastric volvulus is an uncommon cause of recurrent abdominal pain. Its diagnosis must be suspected in patients where no real organic aetiology can be found. Experience with laparoscopic anterior gastropexy is limited to only a few described cases. Our patient was clinically and radiologically followed-up for 2 years with no evidence of recurrence, either radiological or symptomatic. Several other authors have approached this disease in a similar manner, achieving good results. Laparoscopic gastropexy is not yet defined as the 'gold standard' for treating recurrent gastric volvulus, these results can be viewed optimistically
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