ABSTRACT

Gastric volvulus is a rare, potentially life-threatening condition first described by Berti in 1866. Gastric volvulus may be defined as an abnormal rotation of one part of the stomach around another; the degree of twist varies from 180° to 360° and is associated with closed-loop obstruction and the risk of strangulation. Acute, complete volvulus is most often seen in infancy in contrast to chronic and partial varieties, which more often occur in older children and adults. The stomach is relatively fixed at the esophageal hiatus and at the pyloroduodenal junction and is also stabilized by four ligamentous attachments-the gastrohepatic, gastrosplenic, gastrocolic, and gastrophrenic ligaments. Eventration or herniation of the diaphragm is present in about two-thirds of all children presenting with gastric volvulus. Gastric distension may encourage the development of gastric volvulus. Plain abdominal and chest radiographs are essential. A distended stomach in an abnormal position should suggest the possibility of gastric volvulus.