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'Back-and-Forth Stomach' CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus.
Identificadores del recurso
http://hdl.handle.net/10668/21582
35202185
10.3390/tomography8010019
2379-139X
PMC8878744
https://doi.org/10.3390/tomography8010019
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878744/pdf
Origin
(RISalud-ANDALUCÍA)

File

Title:
'Back-and-Forth Stomach' CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus.
Tema:
back-and-forth stomach
computed tomography
emergency
gastric volvulus
radiology
Acute Disease
Hernia, Hiatal
Humans
Stomach Volvulus
Tomography, X-Ray Computed
Description:
Gastric volvulus (GV) is a life-threatening emergency condition that prompts emergent surgical management. With the advent of high-resolution computed tomography (CT), the role of radiologists in its diagnosis has become essential. Although many cases of GV have been described in the literature, its pathophysiology is still poorly understood. In addition, there is substantial terminological confusion with associated entities such as paraesophageal hernia, upside-down stomach, organo-axial or chronic GV. We conducted a retrospective review of clinical, radiological findings and other relevant data for seven patients with previous radiological diagnoses of a large hiatus hernia who presented with acute GV to the emergency department of our institution. We report data on age, sex, medical history, clinical presentation, imaging, treatment and outcomes for each case. The CT findings at acute presentation showed the antrum lying above the diaphragm and dilated fundus below the diaphragm. By comparing the position of the stomach at acute presentation with previous imaging examinations, we confirmed a hypothesis put forward by a few authors decades ago that re-herniation of the gastric fundus into the abdomen is a common pathophysiologic trigger leading to acute GV. This hypothesis has not been supported by modern imaging examinations. We have provided imaging evidence supporting that the pathophysiology of many GVs is based on caudal re-descent of hiatal hernia into the abdominal cavity. Given the terminological disparity used in the literature in this context, we believe it appropriate to introduce and extend the term 'back-and-forth stomach' to refer to this type of GV.
Idioma:
Autor/Productor:
Láinez Ramos-Bossini, Antonio Jesús
Ruiz Carazo, Eduardo
Rabadán Caravaca, María Dolores
Rights:
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
open access
Date:
2023-05-03T14:22:50Z
2022-01-21
Tipo de recurso:
research article
VoR
Format:
application/pdf

oai_dc

Download XML

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    1. <dc:title>'Back-and-Forth Stomach' CT Imaging Findings of a Pathophysiologic Entity Causing Acute Gastric Volvulus.</dc:title>

    2. <dc:creator>Láinez Ramos-Bossini, Antonio Jesús</dc:creator>

    3. <dc:creator>Ruiz Carazo, Eduardo</dc:creator>

    4. <dc:creator>Rabadán Caravaca, María Dolores</dc:creator>

    5. <dc:subject>back-and-forth stomach</dc:subject>

    6. <dc:subject>computed tomography</dc:subject>

    7. <dc:subject>emergency</dc:subject>

    8. <dc:subject>gastric volvulus</dc:subject>

    9. <dc:subject>radiology</dc:subject>

    10. <dc:subject>Acute Disease</dc:subject>

    11. <dc:subject>Hernia, Hiatal</dc:subject>

    12. <dc:subject>Humans</dc:subject>

    13. <dc:subject>Stomach Volvulus</dc:subject>

    14. <dc:subject>Tomography, X-Ray Computed</dc:subject>

    15. <dc:description>Gastric volvulus (GV) is a life-threatening emergency condition that prompts emergent surgical management. With the advent of high-resolution computed tomography (CT), the role of radiologists in its diagnosis has become essential. Although many cases of GV have been described in the literature, its pathophysiology is still poorly understood. In addition, there is substantial terminological confusion with associated entities such as paraesophageal hernia, upside-down stomach, organo-axial or chronic GV. We conducted a retrospective review of clinical, radiological findings and other relevant data for seven patients with previous radiological diagnoses of a large hiatus hernia who presented with acute GV to the emergency department of our institution. We report data on age, sex, medical history, clinical presentation, imaging, treatment and outcomes for each case. The CT findings at acute presentation showed the antrum lying above the diaphragm and dilated fundus below the diaphragm. By comparing the position of the stomach at acute presentation with previous imaging examinations, we confirmed a hypothesis put forward by a few authors decades ago that re-herniation of the gastric fundus into the abdomen is a common pathophysiologic trigger leading to acute GV. This hypothesis has not been supported by modern imaging examinations. We have provided imaging evidence supporting that the pathophysiology of many GVs is based on caudal re-descent of hiatal hernia into the abdominal cavity. Given the terminological disparity used in the literature in this context, we believe it appropriate to introduce and extend the term 'back-and-forth stomach' to refer to this type of GV.</dc:description>

    16. <dc:date>2023-05-03T14:22:50Z</dc:date>

    17. <dc:date>2023-05-03T14:22:50Z</dc:date>

    18. <dc:date>2022-01-21</dc:date>

    19. <dc:type>research article</dc:type>

    20. <dc:type>VoR</dc:type>

    21. <dc:identifier>http://hdl.handle.net/10668/21582</dc:identifier>

    22. <dc:identifier>35202185</dc:identifier>

    23. <dc:identifier>10.3390/tomography8010019</dc:identifier>

    24. <dc:identifier>2379-139X</dc:identifier>

    25. <dc:identifier>PMC8878744</dc:identifier>

    26. <dc:identifier>https://doi.org/10.3390/tomography8010019</dc:identifier>

    27. <dc:identifier>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878744/pdf</dc:identifier>

    28. <dc:language>en</dc:language>

    29. <dc:rights>Attribution 4.0 International</dc:rights>

    30. <dc:rights>http://creativecommons.org/licenses/by/4.0/</dc:rights>

    31. <dc:rights>open access</dc:rights>

    32. <dc:format>application/pdf</dc:format>

    </oai_dc:dc>

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