CASE REPORTS   

Chirurgia 2012 June;25(3):197-200

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English, Italian

Acute organo-axial gastric volvulus in a newborn with Bochdalek hernia

Cerchia E. ¹, Coviello G. ², Bisozzi L. ², Angotti R. ¹, Di Maggio G. ¹, Messina M. ¹

¹ Section of Pediatric Surgery, Department of Pediatrics, Obstetrics and Reproductive Medicine, Policlynic “LE SCOTTE”, University of Siena, Siena, Italy; ² Section of Radiology, Department of Diagnostic Radiology Services in Emergency, Policlynic “Le Scotte”, University of Siena, Siena, Italy

The purpose of this study is to discuss about diagnosis and treatment of a rare case of an organo-axial gastric volvulus in a newborn with congenital diaphragmatic hernia. Acute gastric volvulus is a rare life-threatening condition if it is not recognized and treated quickly. In a recent review, Cribbs reports in the first month of life 54 cases and only 8 cases after birth. A female neonate with prenatal diagnosis of left congenital diaphragmatic hernia, confirmed at the birth with RX chest and upper gastrointestinal contrast X-ray, that also revealed the presence of an organo-axial gastric volvulus. At the laparotomy, performed in the first four hours from the birth, we derotated gastric volvulus, reduced the herniated organs in abdomen and repaired the diaphragmatic defect. Gastric fixation in this case was not performed for low risk of recurrence. Postoperatively, the radiological studies demonstrated the success of surgery with restored diaphragm and normopositioned stomach. It results very important to search the presence of acute gastric volvulus in each patient with congenital diaphragmatic hernia and suspected high obstruction, because the risk of gastric perforation with associated cardiorespiratory decompensation transforms a delayed surgical correction in a surgical emergency.