A Case of Gastric Volvulus in a 3-year-old Female

3세 소아에서 발생한 Gastric Volvulus 1례

Acute gastric volvulus is uncommon but surgically emergent. Normally, the stomach is held in position by four ligaments: gastrophrenic, gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus and esophagus provides further anchorage. A normal diaphragm also helps to prevent abnormal displacement of abdominal viscera and development of gastric volvulus. Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial volvulus is the rotation of the stomach around an axis extending from the hiatus of the diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around an axis transecting the lesser and greater curvatures of the stomach. The symptoms of gastric volvulus depend on its type, the extent and degree of rotation and obstruction, and associated defects. Classic clinical features of acute gastric volvulus, as by Borchardt in 1904, include unproductive retching, acute, localized epigastric distention, and the inability to pass a NG tube. The presence and severity of these features depend on the degree of gastric obstruction of both the gastroesophageal junction and pyloric outlet. It may be suspected on plain abdominal radiographs and usually confirmed by upper gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to avoid recurrence, and correction of any underlying anatomic abnormality. Any associate defect should be repaired and the stomach must be fixed. The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric volvulus.

위 염전증은 소아에서 드믈지만 응급을 요하는 질환으로 최근 비사출성, 비담즙성 구토를 주소로 내원한 3세 환아에서 치험하였기에 문헌 고찰과 함께 보고하는 바이다.