Acute Paediatric Gastric Volvulus Case Report

Abstract

The authors describe a potentially rare case of acute mesenteroaxial gastric volvulus in a pediatric patient. Gastric volvulus is a rare cause of non-bilious vomiting involving rotation of the stomach around its axis and has its peak incidence in the fifth decade of life. Acute gastric volvulus is a life-threatening, requires a high index of suspicion with prompt diagnosis and treatment to prevent significant morbidity and mortality.

 In this case, a 6-year-old female child presented with nausea, vomiting, retching and epigastric pain. Abdominal distension and these non-specific symptoms prompted attempted passage of a nasogastric tube; further eliciting Bordchadt’s triad (epigastric pain, intractable retching and inability to pass nasogastric ctube) which is specific for gastric volvulus. This was followed by imaging with abdominal ultrasound and CT scan, which revealed a malpositioned pylorus with tight stenosis giving a definitive diagnosis of mesenteroaxial gastric volvulus. The surgical procedure of anterior gastropexy without fundoplication along with gastrostomy was performed. The patient had an uncomplicated perioperative and post-operative course with full resolution of symptoms. It is hopeful that this case will serve as an educational platform for any future cases of gastric volvulus in the country and the region to help promote the early diagnosis and treatment that is needed for this rare but life-threatening surgical emergency.