Surgery for Gastric Volvulus: Variant Presentation means Variant Approach. Prospective Evaluation of Surgical Feasibility and Outcome
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Objectives: This prospective study aimed to illustrate clinical presentation of cases of gastric volvulus and applied management with its short-term outcome. Patients & Methods: The study included 7 patients; 3 males and 4 females with mean age of 55.9+6.6 years. Two patients presented by acute severe epigastric pain with vomiting and intolerance to oral feeding, and underwent laparotomy after investigations. Five patients presented by recurrent epigastric pain with vomiting in three and retching in two patients. Three patients presented by an acute pain attack on top of the recurrent pain. Three patients had previous history of medical treatment for similar attacks; these five cases were fully investigated and diagnosed as chronic gastric volvulus and underwent laparoscopic repair. Results: Laparotomy required non-significantly shorter operative time than laparoscopic approach. However, time till 1st oral intake, till 1 ambulation and postoperative (PO) hospital stay were significantly longer with laparotomy compared to laparoscopy Immediate PO, one patient had laparotomy developed wound infection that was managed conservatively. Throughout a mean follow-up period of 27.6+8.1; range: 12-36 months, one patient had recurrent hiatus hernia at 24 months PO and underwent open repair of her hernia without recurrence once again.