Gastric volvulus in children

The twists and turns of an unusual entity

Sarah K. Oh, Bokyung K. Han, Terry L. Levin, Robyn Murphy, Netta M. Blitman, Carmen Ramos

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Gastric volvulus in children is uncommon, and characteristic radiographic findings might not be recognized. Objective: To present the spectrum of clinical and imaging findings, correlate the type of gastric volvulus with clinical outcome, and identify imaging findings to aid in early diagnosis. Materials and methods: Medical records and imaging findings of ten children with gastric volvulus were reviewed. Imaging included abdominal radiographs, upper gastrointestinal (UGI) series, and CT. The diagnosis (organoaxial, mesenteroaxial or mixed type) was made on the UGI series (n=9) and CT (n=1), and confirmed surgically in seven children. Results: Patients were classified based on presentation: four acute, four chronic, and two neonatal. All of the acute group (three mesenteroaxial and one mixed type) had abnormal radiographic findings: three spherical gastric distension, four paucity of distal gas, three elevated left hemidiaphragm, one overlapping pylorus and gastric fundus, one unusual nasogastric tube course, and one situs inversus. All underwent emergent surgery. Three had diaphragmatic abnormalities. One had heterotaxy. Patients in the chronic group (three organoaxial, one mesenteroaxial) had long-standing symptoms. Most had associated neurologic abnormalities. In the neonatal group, organoaxial volvulus was found incidentally on the UGI series. Conclusion: A spectrum of findings in gastric volvulus exists. Mesenteroaxial volvulus has greater morbidity and mortality. Radiographic findings of spherical gastric dilatation, paucity of distal gas and diaphragmatic elevation are suggestive of acute volvulus, particularly in patients with predisposing factors.

Original languageEnglish (US)
Pages (from-to)297-304
Number of pages8
JournalPediatric Radiology
Volume38
Issue number3
DOIs
StatePublished - Mar 2008

Fingerprint

Stomach Volvulus
Intestinal Volvulus
Gases
Gastric Dilatation
Gastric Fundus
Nervous System Malformations
Situs Inversus
Pylorus
Diagnostic Imaging
Causality
Medical Records
Early Diagnosis
Stomach
Morbidity
Mortality

Keywords

  • Children
  • Gastric volvulus
  • Mesenteroaxial
  • Organoaxial

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology

Cite this

Oh, S. K., Han, B. K., Levin, T. L., Murphy, R., Blitman, N. M., & Ramos, C. (2008). Gastric volvulus in children: The twists and turns of an unusual entity. Pediatric Radiology, 38(3), 297-304. https://doi.org/10.1007/s00247-007-0709-5

Gastric volvulus in children : The twists and turns of an unusual entity. / Oh, Sarah K.; Han, Bokyung K.; Levin, Terry L.; Murphy, Robyn; Blitman, Netta M.; Ramos, Carmen.

In: Pediatric Radiology, Vol. 38, No. 3, 03.2008, p. 297-304.

Research output: Contribution to journalArticle

Oh, SK, Han, BK, Levin, TL, Murphy, R, Blitman, NM & Ramos, C 2008, 'Gastric volvulus in children: The twists and turns of an unusual entity', Pediatric Radiology, vol. 38, no. 3, pp. 297-304. https://doi.org/10.1007/s00247-007-0709-5
Oh, Sarah K. ; Han, Bokyung K. ; Levin, Terry L. ; Murphy, Robyn ; Blitman, Netta M. ; Ramos, Carmen. / Gastric volvulus in children : The twists and turns of an unusual entity. In: Pediatric Radiology. 2008 ; Vol. 38, No. 3. pp. 297-304.
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