Archive | 2019
Acute Organo-Axial Gastric Volvulus – A Complication of Anti-Reflux Surgery
Abstract
Introduction: Acute gastric volvulus is a medico-surgical emergency who necessitate an early diagnostic and treatment Case Presentation: We present a case of a patient with organo-axial gastric volvulus with medical history of Nissen operation by laparotomy for hiatal hernia. Discussions: Organo-axial volvulus occurs when there is a rotation around the cardiopyloric axis. This is the most common type in the world literature, and it has the highest rate of predisposition to visceral strangulation. Conclusion: In case of gastric volvulus, early surgery is mandatory. Non-specific and misleading symptoms and signs may delay the diagnosis and increase the risk of necrosis and perforation. Acute Organo-Axial Gastric Volvulus – A Complication of Anti-Reflux Surgery ARC Journal of Clinical Case Reports Page | 2 Abdominal CT Scan Sagital View Intra-Operative Image that Reveals the Epiploic Flange 3. OPERATIVE TECHNIQUE The procedure was performed by a laparotomy with a median xypho-umbilical incision. The exploration revealed significant gastric dilation and an epiploic flange between the large curvature of the stomach and the diaphragm with the presence of an organo-axial gastric volvulus. Not signs of gastric perforation was observed. The epiploic flange was resected and the stomach was liberated. One drainage tube was place in under diaphragmatic left space. A naso-gastric tube was left in place. 4. POST-OPERATIVE COURSE The post-operative course was marked by the presence of a prolonged functional ileus. The patient resumed bowel movement and oral feeding. The discharge was authorized on the 13th post-operative day.