Thursday, July 15, 2010

Gastric Volvulus




This elderly guy presented with acute renal failure due to vomiting everything he tried to eat or drink for a week. He was rehydrated and decompressed. The images above demonstrate a complete foregut obstruction secondary to herniation and volvulus of the stomach through a large hiatal hernia. On the coronal view, you can actually see the pylorus and dilated 1st part of duodenum in the thorax.

I reduced his elephantine stomach and repaired the crural defect. I also did a pyloroplasty and affixed his fundus to the abdominal wall with a gastropexy. He was eating lukewarm hospital chicken casserole by day three. Fun case.

4 comments:

Anonymous said...

Good Case Buckeye!!!! Guess you have to find something to pass the time with the Indians already mathematically eliminated..
But hey, you've got the Browns, I mean Buckeyes..
Like I said, good case.
And are you really a surgeon? No $50,000 stapler to do the work for you?? You didn't really slice his belly open like they used to in the 1940's, you know, the last time the Indians won a World Series.
And Kudos for mentioning the Gas Passer, how come you hate CRNA's???
Thanks for increasing my word power, I never knew "Elephantine" was a real word, which means "Of great mass, Bulky, like an Elephant" but of course you already knew that, because of those great Ohio Pubic Schools...
Its also an Island on the lower Nile, reknowned in ancient times for its Ivory...
Any chance on Ohio State joining the SEC, I've been to Ohio, its really just Georgia with Snow and 20% Unemployment.
Vanderbilt needs someone they can beat...

Frank "SEC Rules" Drackman

Kellie said...

That is fun stuff :)

Sergiu said...

What's the status of the patient Buckeye?

Jeffrey Parks MD FACS said...

Serg-
Patient is fine? Did you think otherwise??