Volvulus of the stomach

Volvulus of the stomach is a severe, infrequent disease, manifested by the rotation of the stomach within its longitudinal or transverse axis. Malformations, elongation or absence of the ligamentous apparatus, diaphragmatic hernia, sudden weight loss, etc. are considered predisposing factors for gastric volvulus.

The reasons

Direct producing factors are: abundant intake of roughage, a sharp increase in intra-abdominal pressure (trauma, weight lifting), etc.

Symptoms

The disease begins acutely with a sharp pain in the epigastric region, radiating to the back, and the appearance of vomiting. After some time, the discharge of vomit becomes unbelievable due to the occlusion of the lumen in the twisted stomach, but the agonizing urge to vomit persists. Often there is dysphagia.

Diagnosis

The clinical picture of gastric volvulus resembles a strangulated diaphragmatic hernia. A distinctive feature is the swelling of the upper left quadrant of the abdomen (with diaphragmatic hernia – retraction in this area of ​​the abdomen), where increased peristalsis of the stomach can be visually traced.

An attempt to insert a gastric tube is traditionally unsuccessful due to obstruction of the esophageal-gastric junction. An urgent x-ray examination in a hospital helps to clarify the diagnosis.

Treatment

Patients need urgent hospitalization in a surgical hospital for emergency surgery – straightening the volvulus and emptying the stomach cavity through a tube.

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