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Gastric volvulus is a condition where the stomach twists, causing blockage and sometimes cutting off blood supply. Symptoms include severe pain and difficulty vomiting. Acute cases require emergency surgery, while chronic cases have vague symptoms and may be confused with other diseases. Diagnosis is done through X-rays, and treatment involves surgery or endoscopy.
Gastric volvulus occurs when the stomach twists, causing a blockage of the intestines. Sometimes it is possible for the stomach to rotate enough to cut off the blood supply, leading to gangrene. In acute gastric volvulus, which occurs suddenly, symptoms include severe pain just below the breastbone and gagging without being able to vomit properly. Your doctor will find it impossible to pass a tube into your stomach. Acute gastric volvulus is an emergency and usually requires surgical treatment.
Most often, gastric volvulus involves the stomach rotating along its length. This is known as organoaxial gastric volvulus and is most frequently associated with disruption of the blood supply to the stomach. Occasionally, a variation called mesenteroaxial gastric volvulus occurs, in which the stomach turns upside down and the back of the organ ends up facing the front of the body. This is less likely to completely block the intestines or obstruct the blood supply to the stomach and can result in what is termed a chronic condition, where symptoms come and go over a longer period. Gastric volvulus occurs more commonly in older people because the supporting ligaments of the stomach become looser with age.
In the acute form of the condition, in addition to pain and retching, there may be swelling of the upper abdomen and shortness of breath. The lower abdomen may lie flat and feel soft. In some cases, the pain can travel from the chest down the arms to the neck.
The chronic condition is more difficult to diagnose, with pain below the breastbone being experienced from time to time. You may experience a feeling of fullness soon after starting a meal, along with shortness of breath and trouble swallowing. Since the symptoms are vague, the condition can be confused with other diseases such as duodenal ulcers.
Gastric volvulus is usually diagnosed using X-rays, and treatment for the acute condition involves surgery to loosen the stomach and fix it in place to prevent a recurrence. At the same time, any dead tissue due to gangrene is removed. In some cases of chronic volvulus, an endoscope, a long, thin telescope-like instrument, may be used to perform keyhole surgery. This technique can be used to return the stomach to its original position, but there is a risk of puncturing the stomach wall. It is useful for patients who are not fit enough to undergo open surgery; it can be performed provisionally, with traditional surgery scheduled at a later date.
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