A Case of Acute Gastric Volvulus Resulting in Panperitonitis Due to Gastric Perforation

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  • Masuya Ryuta
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Nakame Kazuhiko
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Tate Mayumi
    Division of Pediatrics, Department of Developmental and Urological-Reproductive Medicine, Faculty of Medicine, University of Miyazaki
  • Kurogi Jun
    Division of Pediatrics, Department of Developmental and Urological-Reproductive Medicine, Faculty of Medicine, University of Miyazaki
  • Kawano Fumiaki
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Ichihara Akiko
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Ikeda Takuto
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Takeno Shinsuke
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Nanashima Atsushi
    Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Ieiri Satoshi
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University

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Other Title
  • 胃穿孔による汎発性腹膜炎を生じた急性胃軸捻転の1例
  • イ センコウ ニ ヨル ハンハツセイ フクマクエン オ ショウジタ キュウセイ イジク ネンテン ノ 1レイ

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<p>The patient was a two-year-old girl who had been treated for recurrent vomiting for three days. She was brought to our hospital after her previous doctor suspected gastrointestinal perforation due to sudden abdominal distension. When she arrived at our hospital, her face was pale, her vitality was poor, and she had a peripheral cold sensation. Her pulse rate was 200/min, her blood pressure was 60/42 mmHg, her respiratory rate was 43/min, and she was in shock. Contrast-enhanced computed tomography (CT) of the abdomen showed a large amount of free air and ascites along with findings of gastric volvulus. Emergency laparoscopic surgery was performed. The gastric volvulus was corrected laparoscopically. Because the site of perforation was challenging to identify, we changed the procedure to open laparotomy. A pinhole perforation was found at the upper gastric corpus due to detachment of the omentum. Wedge-shaped resection was performed around the perforation, and the stomach was fixed to the abdominal wall. No migrating spleen was observed. The postoperative recovery from disseminated intravascular coagulation and improvement of gastric peristalsis took a few days, but she gradually improved. She was discharged on the 19th postoperative day. Since her discharge from the hospital, there has been no recurrence of volvulus. There have been several reports on gastric perforation associated with acute gastric volvulus. Since there have been some reports of death due to the rapid and severe onset of symptoms, a prompt diagnosis and treatment are required.</p>

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