• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.89-92
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• 2000

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.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.218-224
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• 1981

Acute gastric volvulus is one of the most fatal complications of the eventration of diaphragm and require emergency surgical treatment unless it is possible to pass a nasogatric tube. This 10 year old female patient was admitted because of severe abdominal pain and marked abdominal distention before about 3 days. On chest P-A and plain abdomen, there were the elevation of the left hemidiaphragm and marked dilatation of stomach and the triad of symptoms emphasized by Bochdalek in 1904 was present. Emergency operation [wedge resection of necrotic area of stomach and gastropexy after gastric decompression and plication of diaphragm] was performed. The type of gastric volvulus was organo-axial rotation, in which the stomach rotated around the line that connects the cardia with the pylorus [Fig. 4].

• Journal of Veterinary Clinics
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• v.32 no.3
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• pp.255-258
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• 2015

Gastric dilatation and volvulus (GDV) is an acute and life-threatening disease most commonly affecting large- and giant-breed dogs. However a 17-year-old Shih-tzu (4 kg, spayed female) was hospitalized for acute GDV. Repeated unproductive retching, lethargy, and excessively enlarged abdomen were observed. Physical examination indicated that the patient had suffered from hypothermia ($36.5^{\circ}C$), tachycardia (240 bpm), slowed capillary refill time (> 2 sec.), and pale mucous membrane. Grade III murmur with normal lung sound was auscultated. Abdominal palpation revealed that tympanic regions existed in both the left and right sides. Systolic blood pressure decreased gradually from 220 to 40 mmHg within 4 hours. In blood analysis, slight azotemia was observed by blood urea nitrogen (BUN; 29.1 mg/dl) and creatinine (1.6 mg/dl). Blood lactate concentration (8.13 mmol/l) was severely elevated. Additionally, dilatation and volvulus of the stomach was observed by radiograph. Supportive oxygen, heat, fluid, and drugs were administered with gastric decompressions (e.g., gastrocentesis and nasogastric tube). However the patient entered into comatose status with uncontrollable systolic blood pressure, despite the administration of dobutamine intravenously. The case was closed by euthanasia, considering welfare and age. We finally diagnosed the patient as a GDV, thus this is the first GDV case report in small-breed dog such as Shih-tzu.