From the Research
The treatment of mesenteroaxial gastric volvulus typically requires prompt surgical intervention, with the most recent and highest quality study 1 supporting the use of urgent intervention to prevent gastric ischemia and necrosis. The initial management includes nasogastric tube decompression, fluid resuscitation, and correction of electrolyte abnormalities, followed by definitive surgical repair. The surgical approach depends on the patient's condition and may include laparoscopic or open techniques to reduce the volvulus and prevent recurrence. Some key points to consider in the treatment of mesenteroaxial gastric volvulus include:
- The primary surgical procedures include gastropexy (fixing the stomach to the abdominal wall), repair of any associated hiatal hernia, and possibly a gastrostomy tube placement.
- In cases with gastric necrosis, partial gastrectomy may be necessary, as reported in a case study 2.
- For high-risk surgical patients, endoscopic reduction with or without percutaneous endoscopic gastrostomy (PEG) tube placement may be considered as a temporizing measure.
- Post-operative care includes gradual advancement of diet, pain management, and monitoring for complications such as recurrence, infection, or delayed gastric emptying.
- Prompt treatment is essential as gastric volvulus carries significant mortality risk if left untreated due to potential complications including strangulation, ischemia, necrosis, and perforation, as highlighted in a study 3.
- Long-term follow-up is recommended to monitor for recurrence, especially in patients with predisposing anatomical factors, as noted in a case report 4.