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Gastric volvulus: a potentially fatal cause of acute abdominal pain.

Abstract A woman aged 67 years attended the emergency department with acute abdominal and back pain of 1-day duration with associated vomiting. The patient had multiorgan failure. Resuscitation was started with intravenous fluids and vasopressors. An abdominal CT scan was completed which confirmed the diagnosis of acute gastric volvulus. The patient was successfully resuscitated from a cardiorespiratory arrest during transfer to the operating theatre. The patient subsequently underwent a total gastrectomy with stapling of the oesophageal and duodenal stumps. The abdomen was packed and left open as a laparostomy with a planned relook 48 hours later was to be performed. Unfortunately, the patient continued to deteriorate postoperatively in the intensive care unit despite maximum organ support for multiorgan failure. A decision was made to withdraw treatment and the patient died 10 hours postoperative. This case illustrates the presentation of acute gastric volvulus at a late stage and the high mortality rate associated with it.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title bmj case reports
Publication Year Start




PMID- 28275016
OWN - NLM
STAT- MEDLINE
DA  - 20170309
DCOM- 20170316
LR  - 20170316
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2017
DP  - 2017 Mar 08
TI  - Gastric volvulus: a potentially fatal cause of acute abdominal pain.
LID - bcr2016217708 [pii]
LID - 10.1136/bcr-2016-217708 [doi]
AB  - A woman aged 67 years attended the emergency department with acute abdominal and 
      back pain of 1-day duration with associated vomiting. The patient had multiorgan 
      failure. Resuscitation was started with intravenous fluids and vasopressors. An
      abdominal CT scan was completed which confirmed the diagnosis of acute gastric
      volvulus. The patient was successfully resuscitated from a cardiorespiratory
      arrest during transfer to the operating theatre. The patient subsequently
      underwent a total gastrectomy with stapling of the oesophageal and duodenal
      stumps. The abdomen was packed and left open as a laparostomy with a planned
      relook 48 hours later was to be performed. Unfortunately, the patient continued
      to deteriorate postoperatively in the intensive care unit despite maximum organ
      support for multiorgan failure. A decision was made to withdraw treatment and the
      patient died 10 hours postoperative. This case illustrates the presentation of
      acute gastric volvulus at a late stage and the high mortality rate associated
      with it.
CI  - 2017 BMJ Publishing Group Ltd.
FAU - Sleiwah, A
AU  - Sleiwah A
AD  - Department of Plastic Surgery, NIMDTA, Belfast, UK.
FAU - Thomas, G
AU  - Thomas G
AD  - Department of General Surgery, Western Trust, Enniskillen, UK.
FAU - Crawford, I
AU  - Crawford I
AD  - Department of Emergency Medicine, South West Acute Hospital, Enniskillen, UK.
FAU - Stanek, A
AU  - Stanek A
AD  - Department of General Surgery, South West Acute Hospital, Enniskillen, UK.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170308
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
SB  - IM
MH  - Abdominal Pain/*etiology
MH  - Aged
MH  - Fatal Outcome
MH  - Female
MH  - Gastrectomy
MH  - Humans
MH  - Stomach Volvulus/*diagnostic imaging/*surgery
MH  - Tomography, X-Ray Computed
MH  - Vomiting/etiology
EDAT- 2017/03/10 06:00
MHDA- 2017/03/17 06:00
CRDT- 2017/03/10 06:00
AID - bcr-2016-217708 [pii]
AID - 10.1136/bcr-2016-217708 [doi]
PST - epublish
SO  - BMJ Case Rep. 2017 Mar 8;2017. pii: bcr2016217708. doi: 10.1136/bcr-2016-217708.

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