ABSTRACT
Antenatal polyhydramnios and a small stomach may be noted. Postnatally, the most frequent presenting signs are vomiting, aspiration pneumonia, diarrhoea and failure to thrive. Most spontaneous gastric perforations occur along the greater curvature of the stomach distal to the oesophagus. Perforation due to a duodenal ulcer in infancy occurs on the anterior wall of the duodenum or near the pyloroduodenal junction, whereas gastric ulcers may perforate along the lesser curvature near the antralfundic junction. The radiographic features of acute volvulus include localised massive distension of the upper abdomen, higher greater curvature of the stomach, greater curvature crossing the stomach, possible evidence of a hiatal sacculation or other diaphragmatic herniation and deviation of the position of the spleen. Microgastria is usually temporised using jejunal feeds. The jejunal feedings supplement the smaller oral feedings, allowing the stomach to enlarge. A distended stomach in an abnormal position should raise suspicion of gastric volvulus.
