Clinical manifestations of neonatal gastric volvulus

Neonatal gastric torsion is a particularly serious disease, so many parents, when their children have neonatal gastric torsion, want to fully understand the clinical manifestations of neonatal gastric torsion in order to protect their children's health. The following content introduces the clinical manifestations of neonatal gastric torsion in detail for many parents. You can continue to learn about it as soon as possible.

Neonatal gastric torsion is caused by a disorder in the fixation mechanism of the normal position of the stomach or lesions in its adjacent organs, which leads to gastric displacement, causing the stomach itself to twist abnormally along different axes, with the entire stomach or part of the stomach changing its shape. Gastric volvulus is uncommon. Its acute form develops rapidly, is difficult to diagnose, and often delays treatment. Its chronic form has atypical symptoms and is not easy to detect in time.

Clinical manifestations

Acute gastric volvulus has a sudden onset and develops rapidly. Its clinical manifestations are quite similar to acute abdomen such as acute perforation of ulcer disease, acute pancreatitis, and acute intestinal obstruction. It is sometimes difficult to distinguish it from acute gastric dilatation. At the onset of the disease, there is sudden and severe upper abdominal pain that involves the back. It is often accompanied by frequent vomiting and belching, and the vomitus does not contain bile. If it is proximal gastric obstruction, it will be dry retching. At this time, a gastrointestinal decompression tube is intended to be placed, but it often cannot be inserted into the stomach. Physical examination revealed a distended upper abdomen and a flat lower abdomen. If the degree of torsion is complete and the obstruction site is in the proximal stomach, there will be the above-mentioned typical manifestations of localized distension of the upper abdomen, retching and inability to insert a gastric tube. If the degree of torsion is mild, the clinical manifestations are very atypical. Abdominal X-rays often show an enlarged stomach filled with gas and fluid. Since barium cannot be swallowed, gastrointestinal X-ray examinations are generally not very helpful in the acute phase. Acute gastric volvulus can often only be diagnosed during surgical exploration.

Chronic gastric volvulus is often partial in nature, without obstruction, and may have no obvious symptoms, or its symptoms may be relatively mild, similar to chronic diseases such as ulcer disease or chronic cholecystitis. Gastrointestinal barium meal examination is an important diagnostic method. The X-ray manifestation of mesenteric axis torsion is a double-peaked gastric cavity, that is, the gastric cavity has two fluid levels, and the pylorus and cardia are in similar planes. The X-ray manifestations of organ axis torsion include inverted greater and lesser curvatures of the stomach and the fluid level at the fundus of the stomach not being connected to the body of the stomach.

[Clinical and pathological]

Gastric torsion is often related to congenital developmental abnormalities of the surrounding ligaments, such as excessive length or relaxation of the gastrocolic ligament and hepatogastric ligament. It may also be secondary to the pushing and pulling of diaphragmatic bulge, diaphragmatic hernia, or ulcers, tumors and other factors, or it may occur without any inducement.

According to the different ways of twisting, it can be divided into three types: 1) organ axis or longitudinal axis torsion, that is, with the line connecting the cardia and pylorus as the axis, it flips upward, causing the lesser curvature to point downward and the greater curvature to point upward; 2) omentum axis or transverse axis torsion, that is, it flips to the left or right in a direction perpendicular to the long axis; 3) mixed torsion, which has different degrees of twisting of the above two types. Among the three types, organ axial torsion is the most common, followed by omental axial torsion, and the mixed type is rare.

Acute volvulus is characterized by a sudden onset, persistent retching, little or no vomitus, sudden severe and transient chest or upper abdominal pain, and difficulty inserting a gastric tube into the stomach. The symptoms of chronic gastric volvulus vary in severity and may include non-specific symptoms such as bloating after eating and upper abdominal burning.

Clinical manifestations of neonatal gastric volvulus. Many parents have learned about the clinical manifestations of neonatal gastric volvulus in detail through the above examinations. Therefore, after understanding the clinical manifestations, in order to make their children recover as soon as possible after gastric volvulus, they must choose a regular hospital and receive comprehensive treatment to make their children's stomach healthier.