Inanc Irem, Yildiz Sadettin, Basaran Umit Nusret, Avlan Dincer
Department of Pediatric Surgery, Trakya University Faculty of Medicine, 22030, Edirne, Turkey.
Department of Pediatric Surgery, Division of Pediatric Urology, Trakya University Faculty of Medicine, 22030, Edirne, Turkey.
Pediatr Surg Int. 2025 May 5;41(1):131. doi: 10.1007/s00383-025-06007-9.
This study evaluates the outcomes of conservative management of chronic gastric volvulus in a series of neonates, with a focus on diagnostic and therapeutic approaches.
A retrospective review was conducted on 13 patients diagnosed with chronic gastric volvulus between 2015 and 2024. The clinical and imaging data were analyzed, including age at diagnosis, sex, presenting symptoms, treatment type, and follow-up outcomes. Diagnosis was confirmed with contrast-enhanced upper gastrointestinal radiography. Conservative treatment involved gradual enteral feeding via orogastric tube, specific positional strategies, and total parenteral nutrition.
Of the 13 patients (7 female, 6 male; mean age: 39.23 days), 12 were successfully managed conservatively, with only one requiring surgical gastropexy. The most common presenting symptom was non-bilious vomiting. The mean follow-up was 30.61 months (95% CI: 18.37-42.86 months) revealed all patients achieved weight above the 10th percentile. Conservative management showed a 90.9% success rate, significantly higher than previously reported rates.
Chronic gastric volvulus, often misdiagnosed as GERD, requires clinical suspicion and contrast-enhanced imaging for accurate diagnosis. Conservative management is effective, reducing the need for surgical intervention when standardized protocols are applied.
本研究评估一系列新生儿慢性胃扭转保守治疗的结果，重点关注诊断和治疗方法。
对2015年至2024年间诊断为慢性胃扭转的13例患者进行回顾性研究。分析临床和影像学数据，包括诊断时的年龄、性别、症状表现、治疗类型和随访结果。通过上消化道造影增强检查确诊。保守治疗包括经口胃管逐渐肠内喂养、特定的体位策略和全胃肠外营养。
13例患者（7例女性，6例男性；平均年龄：39.23天）中，12例通过保守治疗成功治愈，仅1例需要手术胃固定术。最常见的症状表现是非胆汁性呕吐。平均随访30.61个月（95%置信区间：18.37 - 42.86个月）显示所有患者体重均达到第10百分位以上。保守治疗成功率为90.9%，显著高于先前报道的比率。
慢性胃扭转常被误诊为胃食管反流病，准确诊断需要临床怀疑和造影增强成像。当应用标准化方案时，保守治疗有效，可减少手术干预的需求。
