Chronic gastric volvulus and hypertrophic pyloric stenosis in an infant

• Published in: Journal of clinical ultrasound Vol. 31; no. 7; pp. 383 - 386
• Main Authors: Anagnostara, Athina, Koumanidou, Chrissoula, Vakaki, Marina, Manoli, Eleni, Kakavakis, Konstantinos
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.09.2003; Wiley
• Subjects: Biological and medical sciences; Chronic Disease; chronic gastric volvulus; Diagnosis, Differential; Digestive system. Abdomen; Humans; hypertrophic pyloric stenosis; Hypertrophy; infancy; Infant; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Pyloric Stenosis - diagnostic imaging; Pyloric Stenosis - surgery; secondary volvulus; Stomach Volvulus - diagnostic imaging; Stomach Volvulus - surgery; Treatment Outcome; Ultrasonic investigative techniques; Ultrasonography; Vomiting - etiology; Sonography; Human; Volvulus; chronic gastric volvulus; Radiodiagnosis; ultrasonography; Stenosis; Infant; infancy; hypertrophic pyloric stenosis; Case study; Radiography; Association; Echography; Pylorus; Digestive diseases; Medical imagery; Barium meal; secondary volvulus; Gastric disease
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.10182

Chronic secondary mesenteroaxial gastric volvulus associated with hypertrophic pyloric stenosis has rarely been mentioned in the general medical literature. We report the case of a 2‐month‐old boy whose clinical symptoms, which included distension of the stomach and projectile vomiting, suggested the diagnosis of hypertrophic pyloric stenosis but who was later diagnosed with chronic secondary mesenteroaxial gastric volvulus. Sonographic examination revealed findings consistent with a rotated stomach, and subsequent plain chest radiography demonstrated a left diaphragmatic eventration. An upper gastrointestinal series radiographic examination with barium contrast enhancement confirmed the diagnosis of mesenteroaxial gastric volvulus. Surgery was performed, and the boy recovered well. A follow‐up sonographic examination performed 3 months post‐operatively revealed no abnormalities. This case demonstrates that primary or secondary gastric volvulus, although rare in children, should be considered in the differential diagnosis of pediatric patients with a history of vomiting. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:383–386, 2003