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World Journal of Pediatrics
Published in: World Journal of Pediatrics 3/2019

01-06-2019 | Gastrostomy | Review Article

Management and outcomes of gastric volvulus in children: a systematic review

Authors: Karina Miura da Costa, Amulya K. Saxena

Published in: World Journal of Pediatrics | Issue 3/2019

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Abstract

Background

Gastric volvulus (GV) in children is a rare condition. This study reviewed management and outcomes of GV in the pediatric population.

Methods

MEDLINE/PubMed, Embase, and Google Scholar databases were searched for studies in English regarding GV in patients < 18 years old between 2008 and 2017, selected by two reviewers. Results were presented as percentages and medians. Fisher’s exact test was used to evaluate categorical variables, and Bonferroni correction was applied for multiple comparisons.

Results

Ninety-seven papers with 125 patients were included. The median age was 24 months, with slightly female preponderance. Vomiting was the most common symptom and acute presentation occurred in the majority of cases. History of previous surgery/abdominal trauma was described in 12 and 3 children, respectively. Radiology was diagnostic for GV in most cases. The initial management was surgical in the majority of cases, with most of them including gastropexy, gastrostomy, or gastric resection. Mesenteroaxial GV was associated with acute presentation (P = 0.004) and the latter with ischemia (P < 0.01). Complications occurred in 23 (18.9%) children, esophageal stenosis being the most common. There were eight (6.4%) deaths, and only one recurrence 6 months after endoscopic management. The median follow-up period was 12 months. The inclusion of only case reports/case series, the incomplete reporting from papers, and the short follow-up were limitations of the study.

Conclusions

GV occurs at a median age of 24 months and requires high suspicion and prompt management, as mortality is considerable. The preferred surgical approach for GV includes variations of gastropexy. Esophageal stenosis is the most common morbidity post-GV management.
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Metadata
Title
Management and outcomes of gastric volvulus in children: a systematic review
Authors
Karina Miura da Costa
Amulya K. Saxena
Publication date
01-06-2019
Publisher
Springer Singapore
Published in
World Journal of Pediatrics / Issue 3/2019
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-019-00244-4

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