[Endoscopic management of gastric volvulus in a 8-years old girl].

INTRODUCTION

Gastric volvulus is a rare cause of acute abdomen in childhood, and it is usually a casual finding. We present the case of a girl with mesenteroaxial gastric volvulus, which was initially treated by endoscopic approach.

CLINICAL CASE: 8 year-old patient, diagnosed of Down syndrome, who presented sudden and diffuse colic pain, associated with vomiting, sialorrhea and progressive compromise. She entered in bad general condition. At the physical examination it was highlighted a large abdominal mass. In the imaging study, a mesenteroaxial gastric volvulus and wandering spleen were confirmed. It was decided to perform an endoscopic gastric devolvulation under general anesthesia. Subsequently, gastropexy and splenopexy were performed by laparotomic approach. Evolution was uneventful, being discharged at the tenth postoperative day.

COMMENTS: Endoscopic gastric devolvulation is an effective procedure in patients with gastric volvulus, especially in cases of great compromise of the general state, in which a prolonged surgery could suppose a greater risk.