Pediatr Gastroenterol Hepatol Nutr.  2019 Nov;22(6):608-612. 10.5223/pghn.2019.22.6.608.

Chronic Gastric Volvulus as a Late Complication of Hepatectomy for Hepatoblastoma in a Child: A Case Report

• Lee HS
• Jung EJ
• Park JS
• Park T

• KMID: 2462103
• DOI: http://doi.org/10.5223/pghn.2019.22.6.608

Abstract

Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.

Keyword

Stomach volvulus; Hepatectomy

MeSH Terms

Abdominal Pain
Child*
Diaphragm
Gastropexy
Hepatectomy*
Hepatoblastoma*
Hernia, Hiatal
Hernias, Diaphragmatic, Congenital
Humans
Male
Pathology
Rare Diseases
Stomach Volvulus*
Wandering Spleen

Figure

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  Fig. 1 (A, B) Upper gastrointestinal study shows delayed contrast media with antral deformity.

• 

  Fig. 2 (A) Operative finding shows multiple adhesions in the abdominal wall. (B) Operative finding shows greater curvature of stomach attached to the liver.

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  Fig. 3 Intraoperative views. (A) The completion of adhesiolysis. (B) Anterior wall gastropexy was done with absorbable suture.

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