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Research: Acute massive gastric dilatation: a rare, forgotten complication of fundoplication.

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Research: Acute massive gastric dilatation: a rare, forgotten complication of fundoplication.

BMJ Case Rep. 2020 May 27;13(5). pii: e232479. doi: 10.1136/bcr-2019-232479. https://pmlegacy.ncbi.nlm.nih.gov/pubmed/32467115

Acute massive gastric dilatation: a rare, forgotten complication of fundoplication.

Lau SE#1Boam T#2,3Parsons S4Motiwale S3.

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Abstract

An 8-year-old boy with a history of multiple neonatal laparotomies, including congenital diaphragmatic hernia repair and an open fundoplication, presented acutely with severe abdominal pain, distension, vomiting and shock. A large abnormal opacity in the left upper quadrant was visible on a plain abdominal radiograph. The patient was taken to the theatre for emergency laparotomy and was found to have a massively distended stomach, the fundus and body of which were necrotic. A subtotal gastrectomy was performed, sparing the viable tissue. The patient went on to make a full recovery. Acute massive gastric dilatation (AMGD) is a rare condition characterised by severe gastric distension. Gastric ischaemia results when intragastric pressure exceeds venous pressure, obstructing venous outflow. It is important to recognise AMGD as a severe complication of fundoplication due to closed-loop gastric obstruction. It should prompt consideration of an early laparotomy in cases where the diagnosis is suspected.

© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

KEYWORDS:

gastrointestinal surgery; paediatric surgeryPMID: 32467115 DOI: 10.1136/bcr-2019-232479

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