Conservative management of chronic gastric volvulus: 44 cases over 5 years

Yao Chun Hsu, Chin Lin Perng, Chun Ku Chen, Jai Jen Tsai, Hwai Jeng Lin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

AIM: To investigate clinical outcomes of patients with chronic gastric volvulus (GV) who were managed conservatively over a 5-year period. METHODS: A total of 44 consecutive patients with chronic GV, as diagnosed by barium study between October 2002 and July 2008 were investigated. All of these patients received conservative management initially without anatomical correction. Their clinical manifestations, diagnostic work-ups, and clinical outcomes were analyzed. We sought to identify independent risk factors for poor outcome by using the Cox proportional hazards model. RESULTS: The enrolled patients were predominantly male (n = 37, 84%) and of advanced age (median: 71 years old, interquartile range: 57.5-78 years). Abdominal pain and fullness were the most common presentations. During the follow-up period (median: 16 mo, up to 69 mo), there was no severe complication, but symptomatic recurrence was noted in 28 patients (64%). Only one patient turned to elective surgery for frequent symptoms. Peritoneal adhesion was the only independent risk factor associated with recurrence (hazard ratio: 2.58, 95% CI: 1.08-6.13, P = 0.033). CONCLUSION: Symptomatic recurrence of chronic GV is very common although serious complications infrequently occur with conservative management. Peritoneal adhesion is independently associated with recurrence.

Original languageEnglish
Pages (from-to)4200-4205
Number of pages6
JournalWorld Journal of Gastroenterology
Volume16
Issue number33
DOIs
Publication statusPublished - Sep 7 2010
Externally publishedYes

Keywords

  • Barium study
  • Conservative treatment
  • Gastric volvulus
  • Peritoneal adhesion
  • Upper gastrointestinal tract

ASJC Scopus subject areas

  • Gastroenterology

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