Case Report of Incarcerated Gastric Volvulus and Splenic Herniation in Undiagnosed Congenital Diaphragmatic Hernia in an Infant.

Abstract

Congenital diaphragmatic hernia is usually diagnosed prenatally and surgically repaired within the first few days of life. It is very rarely associated with acute gastric volvulus, an uncommon surgical emergency in children. A male infant with atypical presentation of acute gastric volvulus was diagnosed and treated by a swift-acting team across two medical centers. The patient presented with generalized abdominal distention and non-productive retching. Upper gastrointestinal series diagnosed acute gastric volvulus. During laparoscopic intervention, the volvulized stomach and the spleen were identified within an undiagnosed congenital diaphragmatic hernia. Corrective surgery was performed, and the patient tolerated a regular diet within days and continues to do well. Given the emergent nature of acute gastric volvulus in children, a high index of suspicion is warranted to quickly initiate potentially life-saving diagnostics and treatment.

Topics: Acute gastric volvulus, diaphragmatic hernia, pediatric.