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J Thorac Cardiovasc Surg 2005;130:1722-1723
© 2005 The American Association for Thoracic Surgery

Brief Communications

Acute intrathoracic gastric volvulus after laparoscopic fundoplication: Laparoscopic reduction and repair

Vishwanath Golash, MS, FRCS *

Department of Surgery, Sultan Qaboos Hospital, Salalah, Sultanate of Oman

* Address for reprints: Vishwanath Golash, MS, FRCS, Sultan Qaboos Hospital, PO Box 98, Salalah, Pin Code 211, Sultanate of Oman (Email: golash@omantel.net.om; haritagolash@hotmail.com).

The first 20% of the full text of this article appears below.


Figure 1
Dr Golash


Acute gastric volvulus is extremely rare after laparoscopic fundoplication. It is a true surgical emergency, and a delay in diagnosis can lead to fatal complications. Once the diagnosis is confirmed, nasogastric and gastroscopic decompression should be attempted. The surgical treatment involves reduction of the volvulus and prevention of recurrence. We present a patient who had an acute gastric volvulus after a Nissen fundoplication managed laparoscopically.

Introduction

Gastric volvulus can present acutely or chronically depending on the speed of onset of rotation and the extent of twist. It can also be classified on the basis of the axis of rotation. Organoaxial is the most common and is usually associated with a hiatus hernia. It classically presents with the clinical triad of retching, epigastric pain, and difficulty in passing a nasogastric tube.

Clinical Summary

A 23-year-old man presented with a 1-day history of increasingly severe upper abdominal and lower chest pain radiating to the back, retching, and . . . [Full Text of this Article]






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