Abstract
Purpose
In this study, we aimed to evaluate the diagnostic performance of ultrasound for gastric volvulus. The characteristics of patients with gastric volvulus were also evaluated.Methods
Thirty-seven pediatric patients with gastric volvulus, diagnosed based on an upper gastrointestinal series, were classified into two groups: organoaxial and mesenteroaxial. The diagnostic performance of ultrasound for gastric volvulus and its usefulness in the management of these patients were also examined. Age, symptom onset, and presence/absence of diaphragmatic elevation/hernia, scoliosis, and wandering spleen of the two groups were compared using Fisher's exact and the Mann-Whitney U test.Results
Among the 37 eligible patients, 28/9 had organoaxial/ mesenteroaxial gastric volvulus, respectively. Seven of these patients (18.9%) were correctly diagnosed using ultrasound. In 31/37 patients, ultrasound ruled out other disease-related symptoms indicative of gastric volvulus. Significant inter-group differences were observed for age (age (years) with organoaxial vs. mesenteroaxial gastric volvlulus = 2.24 ± 4.22 [0.01-14.98] vs.5.77 ± 4.45 [0.23-15.87], P = 0.010), acute/chronic onset of symptom (acute/chronic onset of symptom with organoaxial vs. mesentaroaxial gastric volvlulus = 5/23 vs. 5/4, P = 0.041), wandering spleen (present/absent of those with organoaxial vs. mesenteroaxial gastric volvulus = 0/28 vs. 6/3, P = 0.001), and scoliosis (present/absent of those with organoaxial vs, mesenteroaxial gastric volvulus = 1/27 vs. 3/6, P = 0.038).Conclusion
To our knowledge, this study is the first to demonstrate the diagnostic performance of ultrasound for gastric volvulus. Although small number of cases of gastric volvulus were diagnosed using ultrasound, its diagnostic performance was unreliable. However, ultrasound was useful in differentiating gastric volvulus from other diseases with similar symptoms.