A case report on gastric volvulus of a 17 years old boy from Bangladesh.
M Tasdik Hasan, S M Tajdit Rahman, Hasan M Shihab, Hassan Rushekh Mahmood, Tanni Chowdhury, Quamrul Akhtar Sanju
Author Information
M Tasdik Hasan: Shaheed Suhrawardy Medical College, Sher-e-Bangla Nagar, Dhaka, Bangladesh; International Center for Diarrhoeal Diseases Research, Bangladesh, Mohakhali, Dhaka, Bangladesh. Electronic address: tasdikhdip@yahoo.com.
S M Tajdit Rahman: National Institute of Diseases of the Chest & Hospital, Mohakhali, Dhaka, Bangladesh. Electronic address: tanims@ymail.com.
Hasan M Shihab: Combined Family Medicine and Preventive Medicine Program, MedStar Franklin Square Medical Center and Johns Hopkins Bloomberg School of Public Health, USA. Electronic address: hshihab1@jhmi.edu.
Hassan Rushekh Mahmood: Shaheed Suhrawardy Medical College, Sher-e-Bangla Nagar, Dhaka, Bangladesh; International Center for Diarrhoeal Diseases Research, Bangladesh, Mohakhali, Dhaka, Bangladesh. Electronic address: dr.rossi82@gmail.com.
INTRODUCTION: gastric volvulus is a rare and true surgical emergency which is life threatening if not recognized and treated quickly. There have been approximately 300 reported cases globally till now. This condition most often occurs during 5th decade of life but there are over 100 reported pediatric cases also. This following rare incidence was such a case of a young patient in Bangladesh. It was the first case of gastric volvulus managed by the surgery department of the concerned hospital. PRESENTATION OF CASE: A 17year old boy with frequent post meal vomiting presented with abdominal fullness and mild upper abdominal pain for 2 months. He was absolutely constipated for 2 weeks. On examination, there was distension of abdomen with mild tenderness. He had no significant respiratory distress. Plain X-ray revealed elevation of left hemi-diaphragm. The contrast meal study showed organoaxial volvulus of stomach. Elevation of left hemidiaphragm and an ectopic subdiaphragmatic kidney was found in CT scan of chest. DISCUSSION: After adequate preparation, the patient was subjected to laparotomy and anterior gastropexy with plication of left hemi diaphragm was done. gastric volvulus can manifest as an acute abdominal emergency or as a chronic intermittent problem. It requires a high index of suspicion and proper investigation. CONCLUSION: It should be suspected in congenital abnormalities of diaphragm and associate with many other congenital abnormalities like ectopic kidney. Early surgical repair remains the treatment of choice.
