Gastric Volvulus
Abnormal rotation of the stomach causing obstruction — a surgical emergency.
Overview
Gastric volvulus is an uncommon but serious condition where the stomach twists on itself, potentially cutting off its blood supply and blocking the passage of food. Acute volvulus is a surgical emergency. It is often associated with a large hiatus or diaphragmatic hernia and requires prompt surgery to prevent the stomach wall from dying.
Causes
- Large hiatus or diaphragmatic hernia
- Abnormal laxity of the stomach's supporting ligaments
- Previous stomach or diaphragm surgery
- Congenital predisposition
Risk Factors
- Advancing age
- Large hiatus hernia
- Diaphragmatic defects
- Female gender
Symptoms
Diagnosis
- Chest and abdominal X-ray
- CT abdomen (confirms the twist and blood supply)
- Contrast swallow study
- Upper GI endoscopy (with caution)
Treatment Options
Surgical Treatment
Acute gastric volvulus requires emergency surgery to untwist the stomach, assess its viability, and fix it in place (gastropexy) to prevent recurrence. Any associated hiatus or diaphragmatic hernia is repaired at the same time. Dr. Bhagat performs these repairs laparoscopically when the situation allows, or via open surgery in emergencies.
Recovery
Recovery depends on whether the surgery was elective or emergency and whether part of the stomach was damaged. Hospital stay is typically 4–7 days with a graded diet. Fixing the stomach and repairing the hernia gives durable results.
Prevention
- Timely repair of large hiatus/diaphragmatic hernias
- Prompt evaluation of severe upper abdominal pain with retching
- Not ignoring recurrent bloating and swallowing difficulty
Frequently Asked Questions
How urgent is gastric volvulus?
Will it happen again after surgery?
Expert Consultation Available
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