Gastric volvulus: A review of 38 cases

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

Carlos Eduardo Jacob¹  Fábio Pinatel Lopasso¹  Bruno Zilberstein¹  Cláudio José Caldas Bresciani¹  Rogério Kuga¹  Ivan Cecconello¹  Joaquim José Gama-rodrigues¹ 

关键词: Stomach;    Gastric volvulus;    Surgery;    Hiatal hernia;    Estômago;    Volvo gástrico;    Cirurgia;    Hérnia hiatal;   

DOI  :  10.1590/S0102-67202009000200006

来源: SciELO

【 摘 要 】

BACKGROUND: Gastric volvulus is frequently an asymptomatic disease, and it is usually diagnosed during radiographic examination of the superior digestive tract. The acute form, however, can spawn serious and lethal clinical consequences. This disease is defined by the anomalous rotation of the stomach over itself, and it can be classified according to type, extension, direction, etiology, and clinical presentation. AIM: To review the records from 38 patients with gastric volvulus diagnosed in the Hospital das Clínicas of University of São Paulo between 1968 and 2001. METHODS: This is retrospective analysis of 38 patient records. It was collected from each patient: name, age of first symptom appearance, gender, main clinical findings and complementary exams, volvulus type, extension, direction, etiology, and clinical presentation, therapeutic procedures, type of surgery performed, eventual recurrence, and long-term evolution. RESULTS: It was observed that occurrences of gastric volvulus are mainly secondary (75.8%). For the majority of patients (n=33), surgery was chosen as the treatment option: chronic disease in 29 cases and acute in four. Conservative treatment was reserved only for patients with no clinical conditions to surgical treatment. Anterior gastropexy was associated to high recurrence rates. Suturing the low gastric curve to the hepatic capsule and the transverse colon to the left subphrenic space (Tanner´s operation) seemed to be the technical treatment of choice for primary gastric volvulus. CONCLUSION: Treatment of gastric volvolus must be tailored according the etiology of the disease.

【 授权许可】

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