Chronic Organo-axial Gastric Volvulus In infancy and Childhood: Diagnosis and Surgical Management

Background/Purpose: Chronic Organo-Axial Gastric Volvulus (COAGV) is not commonly considered as a cause of persistent vomiting in childhood. This study describes the outcomes of a group of patients seen, diagnosed and treated for this disorder. Materials & Methods: Records of 24 patients with a diagnosis of COAGV who presented to Aseer Central Hospital were retrospectively analyzed for presentation, number of admissions, investigations, treatment undergone and follow up. Results: Vomiting has lead to serious morbidity in 10 of 17 patients aged less than six months. Upper GI studies were diagnostic in all cases, although plain abdominal X-ray may be a useful pointer where clinical suspicion is high. Fundic gastropexy was done in all but four patients. Fourteen patients had good, two fair and three poor outcomes. Out of the four patients treated conservatively two had good and two poor outcomes. There was one mortality in the cases treated surgically. Conclusion: Fundic gastropexy is a safe and expedient modality in the management of COAGV. It avoids the high morbidity occasionally associated with the sequelae of vomiting.