Summary about Disease
Gastric volvulus is a condition where the stomach twists on itself, potentially leading to obstruction of the stomach outlet and/or strangulation of its blood supply. This can result in severe pain, vomiting, and if left untreated, can cause tissue death (necrosis) and be life-threatening. It is relatively rare.
Symptoms
Severe, sudden abdominal pain
Retching without vomiting (or vomiting of small amounts of blood)
Inability to pass a nasogastric tube into the stomach
Abdominal distension
Chest pain
Shortness of breath
Hiccups In chronic cases, symptoms may be milder and intermittent.
Causes
Gastric volvulus can be caused by:
Anatomical defects: Laxity or absence of the ligaments that support the stomach (such as the gastrophrenic, gastrosplenic, and gastrocolic ligaments).
Diaphragmatic hernias: Especially paraesophageal hernias, where part of the stomach protrudes through the diaphragm.
Splenic abnormalities: A wandering spleen can pull on the stomach.
Previous surgery: Prior operations on the stomach or esophagus can weaken supporting structures.
Gastric distension: Excessive air or food in the stomach.
Other: Conditions that increase intra-abdominal pressure.
Medicine Used
Pain Management: Analgesics (pain relievers) are used to manage the severe pain.
Antiemetics: Medications to reduce nausea and vomiting.
Antibiotics: In cases of gastric necrosis or perforation, antibiotics are administered to combat infection.
PPIs (Proton Pump Inhibitors) or H2 blockers: May be used to reduce stomach acid production if conservative management is attempted before surgery. Definitive treatment usually involves surgical intervention rather than medication alone.
Is Communicable
Gastric volvulus is not a communicable disease. It is not caused by an infectious agent and cannot be transmitted from person to person.
Precautions
There are limited precautions one can take to prevent gastric volvulus.
Address underlying conditions: Management of conditions like diaphragmatic hernias may reduce risk.
Avoid overeating: Eating smaller, more frequent meals can prevent acute gastric distension.
Lifestyle modifications: Maintaining a healthy weight and avoiding activities that significantly increase intra-abdominal pressure may be beneficial.
How long does an outbreak last?
Gastric volvulus is not an outbreak-related disease. It is an individual medical condition that arises sporadically.
How is it diagnosed?
X-ray: An abdominal X-ray may show an abnormally positioned stomach with a characteristic gas-filled structure in the chest.
Upper GI series (Barium swallow): This involves drinking a barium solution, which coats the esophagus and stomach, allowing for visualization on X-ray.
CT scan: Computed tomography provides detailed images of the stomach and surrounding structures, helpful in identifying the twist and any complications.
Endoscopy: A flexible tube with a camera is inserted into the esophagus and stomach to visualize the lining and identify the volvulus.
Timeline of Symptoms
The onset of symptoms can be:
Acute: Symptoms develop suddenly and severely, typically within hours. This is the most common presentation.
Chronic/Intermittent: Symptoms are milder and come and go over weeks, months, or even years. These cases can be challenging to diagnose. The timeline depends on the degree of torsion and resulting obstruction/ischemia. Acute volvulus requires immediate attention.
Important Considerations
Gastric volvulus is a potentially life-threatening condition requiring prompt diagnosis and treatment.
Surgical intervention is often necessary to untwist the stomach and prevent recurrence.
Delay in diagnosis and treatment can lead to gastric ischemia, necrosis, perforation, and death.
Chronic volvulus can be difficult to diagnose due to its intermittent and often vague symptoms.
Individuals with known risk factors (e.g., diaphragmatic hernia) should be aware of the potential symptoms and seek medical attention if they develop.