Spontaneous Acute Mesenteroaxial Gastric Volvulus Diagnosed by Computed Tomography Scan in a Young Man

医学 扭转 胃扭转 放射科 计算机断层摄影术 腹痛 急腹症 腹部 急诊科 腹部计算机断层扫描 鉴别诊断 剖腹探查术 上腹部疼痛 呕吐 外科急诊 剖腹手术
作者
Gaby Jabbour,Ibrahim Afifi,Mohamed Ellabib,Ayman El-Menyar,Hassan Al-Thani
出处
期刊:American Journal of Case Reports [International Scientific Information Inc.]
卷期号:17: 283-288 被引量:6
标识
DOI:10.12659/ajcr.896888
摘要

Background Acute gastric volvulus is a surgical emergency that requires early recognition and treatment. Acute idiopathic mesenteroaxial gastric volvulus is a rare sub-type and there are few cases reported in children and there are even fewer reports in adults. Case report We report a rare case of a 23-year-old man who presented with a 1-day history of vomiting, epigastric pain, distention, and constipation. The diagnosis for mesenteroaxial type gastric volvulus was confirmed by abdominal radiography and computed tomography. The patient was successfully treated by laparotomy with resection of the ischemic stomach wall and anastomosis. Acute spontaneous mesenteroaxial gastric volvulus is rare in adults and early diagnosis is challenging due to non-specific symptoms. A missed or delayed diagnosis may result in serious complications due to gastric obstruction. Conclusions A patient presenting with severe epigastric pain and clinical evidence of gastric outlet obstruction should be considered as a surgical emergency to rule out gastric volvulus. High index of suspicion, early diagnosis and prompt surgical management are important for favorable outcome in patients with acute spontaneous gastric volvulus.

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