ACUTE GASTRIC VOLVULUS AND CONGENITAL POSTEROLATERAL DIAPHRAGMATIC-HERNIA

Acute gastric volvulus in infancy is a rare disorder and a surgical em ergency. Prompt clinical suspicion and radiological assessment are ess ential for this life-threatening condition. We report a 3-month-old fe male case, admitted for an initial suspicion of an intestinal obstruct ion, She presented unproductive retching, respiratory distress, epigas tric distension and lethargy, It was not possible to introduce a naso- gastric tube. A radiological contrast study showed an occluded cardio- esophageal junction without passage of barium, two gastric fluid level s and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia, Lapar otomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia, The stomach volvulus was untwist ed, the diaphragmatic defect was repaired after reduction of the herni ated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.