F. Rashid, T. Thangarajah, D. Mulvey, M. Larvin, S.Y. Iftikhar

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Presentation transcript:

A review article on gastric volvulus: A challenge to diagnosis and management F. Rashid, T. Thangarajah, D. Mulvey, M. Larvin, S.Y. Iftikhar International Journal of Surgery Volume 8, Issue 1, Pages 18-24 (January 2010) DOI: 10.1016/j.ijsu.2009.11.002 Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 1 Chest radiograph. This demonstrates kyphoscoliosis and an anterior diaphragmatic hernia containing a partial gastric volvulus. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 2 Abdominal x-ray showing gross scoliosis. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 3 Intraoperative images of the abdominal cavity showing an anterior diaphragmatic hernia. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 4 Upper gastrointestinal contrast series employing barium contrast. (Complete herniation of the stomach into the thoracic cavity). International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 5 Partially twisted stomach being retrieved into the abdominal cavity. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 6 Dissection around the right crus of the diaphragm. Liver was retracted using Nathanson's liver retractor. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 7 Big hiatal hole visible. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 8 Peritoneal sac being divided anterior to the oesophagus. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 9 Grasper is being passed through the posterior oesophageal window. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 10 Dissection of the left crus and the peritoneal sac. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 11 Lower oesophagus is now fully mobilized. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 12 Lower oesophagus is being slinged with the nylon tape. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 13 Gortex suture has been applied from left to right crus of the diaphragm behind the oesophagus. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 14 Loose placement of interrupted Gortex suture to approximate crura anterior to the oesophagus and to create a secure base for placement of porcine mesh. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions

Fig. 15 Repair reinforced with porcine mesh using protac stapler. International Journal of Surgery 2010 8, 18-24DOI: (10.1016/j.ijsu.2009.11.002) Copyright © 2009 Surgical Associates Ltd Terms and Conditions