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Changing patterns in the management of gastric volvulus over 14 years.
Br J Surg. 2000 Mar; 87(3):358-61.BJ

Abstract

BACKGROUND

Gastric volvulus is an uncommon condition, which can be difficult to diagnose and treat. This study represents a large series of patients with the condition.

METHODS

All patients presenting with gastric volvulus over a 14-year period were reviewed.

RESULTS

Some 36 patients (median age 75 years) were identified. Volvulus, usually secondary to a hiatus hernia, presented acutely in 29 patients. The major symptoms were abdominal pain, vomiting and upper gastrointestinal haemorrhage. The most useful investigations were barium contrast studies and upper gastrointestinal endoscopy, which were helpful in 21 of 25 and 11 of 18 patients respectively. Treatment was conservative in five patients, by open surgery in 13 and laparoscopic repair in 18 (three converted to open operation). There were no major complications and no deaths. Median hospital stay was shorter in patients treated by laparoscopic rather than open surgery (6 (range 4-36) versus 14 (7-50) days; P < 0.05).

CONCLUSION

Acute and chronic gastric volvulus can be treated successfully by either open or laparoscopic surgery. However, laparoscopic surgery now represents a safe and acceptable approach, with minimal morbidity and a significantly shorter hospital stay. This is likely to be of considerable benefit for the treatment of a predominantly elderly population, often with significant co-morbidity.

Authors+Show Affiliations

University of Adelaide Department of Surgery, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10718808

Citation

Teague, W J., et al. "Changing Patterns in the Management of Gastric Volvulus Over 14 Years." The British Journal of Surgery, vol. 87, no. 3, 2000, pp. 358-61.
Teague WJ, Ackroyd R, Watson DI, et al. Changing patterns in the management of gastric volvulus over 14 years. Br J Surg. 2000;87(3):358-61.
Teague, W. J., Ackroyd, R., Watson, D. I., & Devitt, P. G. (2000). Changing patterns in the management of gastric volvulus over 14 years. The British Journal of Surgery, 87(3), 358-61.
Teague WJ, et al. Changing Patterns in the Management of Gastric Volvulus Over 14 Years. Br J Surg. 2000;87(3):358-61. PubMed PMID: 10718808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing patterns in the management of gastric volvulus over 14 years. AU - Teague,W J, AU - Ackroyd,R, AU - Watson,D I, AU - Devitt,P G, PY - 2000/3/16/pubmed PY - 2000/3/16/medline PY - 2000/3/16/entrez SP - 358 EP - 61 JF - The British journal of surgery JO - Br J Surg VL - 87 IS - 3 N2 - BACKGROUND: Gastric volvulus is an uncommon condition, which can be difficult to diagnose and treat. This study represents a large series of patients with the condition. METHODS: All patients presenting with gastric volvulus over a 14-year period were reviewed. RESULTS: Some 36 patients (median age 75 years) were identified. Volvulus, usually secondary to a hiatus hernia, presented acutely in 29 patients. The major symptoms were abdominal pain, vomiting and upper gastrointestinal haemorrhage. The most useful investigations were barium contrast studies and upper gastrointestinal endoscopy, which were helpful in 21 of 25 and 11 of 18 patients respectively. Treatment was conservative in five patients, by open surgery in 13 and laparoscopic repair in 18 (three converted to open operation). There were no major complications and no deaths. Median hospital stay was shorter in patients treated by laparoscopic rather than open surgery (6 (range 4-36) versus 14 (7-50) days; P < 0.05). CONCLUSION: Acute and chronic gastric volvulus can be treated successfully by either open or laparoscopic surgery. However, laparoscopic surgery now represents a safe and acceptable approach, with minimal morbidity and a significantly shorter hospital stay. This is likely to be of considerable benefit for the treatment of a predominantly elderly population, often with significant co-morbidity. SN - 0007-1323 UR - https://www.unboundmedicine.com/medline/citation/10718808/Changing_patterns_in_the_management_of_gastric_volvulus_over_14_years_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0007-1323&amp;date=2000&amp;volume=87&amp;issue=3&amp;spage=358 DB - PRIME DP - Unbound Medicine ER -