Gastric Volvulus as a Complication of Laparoscopic Fundoplication and Gastrostomy

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Abstract
Gastric volvulus is rare in children. Volvulus may occur spontaneously secondary to a deficiency of the ligamentous attachments of the stomach, or it may occur postoperatively. Volvulus can occur in two planes: organoaxial and mesenteroaxial. This condition is a surgical emergency and has a significant mortality rate when not treated in a timely fashion. Gastric volvulus following laparoscopic fundoplication and gastrostomy tube has not previously been reported, to the authors' knowledge. This report details the case of a 2-year-old neurologically impaired child who required urgent surgical intervention for a postoperative volvulus. The diagnosis can be made clinically and radiologically. Surgical management requires reduction of the volvulus and gastropexy. Prevention of volvulus following laparoscopic fundoplication and gastrostomy tube requires proper placement of the gastrostomy tube and prevention of postoperative gastric dilatation.

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