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Acute gastric volvulus and congenital posterolateral diaphragmatic hernia.

Abstract
Acute gastric volvulus in infancy is a rare disorder and a surgical emergency. Prompt clinical suspicion and radiological assessment are essential for this life-threatening condition. We report a 3-month-old female case, admitted for an initial suspicion of an intestinal obstruction. She presented unproductive retching, respiratory distress, epigastric distension and lethargy. It was not possible to introduce a naso-gastric tube. A radiological contrast study showed an occluded cardio-esophageal junction without passage of barium, two gastric fluid levels and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia. Laparotomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia. The stomach volvulus was untwisted, the diaphragmatic defect was repaired after reduction of the herniated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.
AuthorsB Leitão, C R Mota, C Enes, P Ferreira, P Vieira, D Requeijo
JournalEuropean journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie (Eur J Pediatr Surg) Vol. 7 Issue 2 Pg. 106-8 (Apr 1997) ISSN: 0939-7248 [Print] United States
PMID9165258 (Publication Type: Case Reports, Journal Article)
Topics
  • Acute Disease
  • Female
  • Hernia, Diaphragmatic (complications, diagnostic imaging)
  • Hernias, Diaphragmatic, Congenital
  • Humans
  • Infant
  • Radiography
  • Stomach Volvulus (complications, diagnostic imaging, surgery)

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