Is gastropexy required for all cases of gastric volvulus in children?

Abstract

Gastric volvulus (GV) is rare in the pediatric age group. The presentation is varied, and surgery in the form of gastropexy is recommended. We examine the place of gastric fixation in the management of these patients. The authors retrospectively reviewed five cases of gastric volvulus treated at their institute and noted presenting symptoms and signs, studies performed, associated anomalies, surgery done, and outcome. All patients had associated diaphragmatic abnormalities. Two patients had acute volvulus; three had a chronic presentation. Chest X-ray and barium meal were diagnostic. All patients underwent surgical correction of the diaphragmatic anomaly with detorsion of the stomach. Gastropexy was done in only one patient. All patients recovered without any complications and have been well. GV must be suspected in the appropriate clinical setting; chest X-rays and barium meals are the best studies in suspected cases. Gastropexy or gastrostomy is not necessary for a successful outcome in secondary volvulus.