Changes

==Treatment==

==Treatment==

Once the patient has been stabilised, the volvulus should be surgically reduced via a cranioventral midline laparotomy. The aims of surgery include gastric decompression and repositioning, assessment of the abdominal organ viability, removal of necrotic tissue and gastropexy.

Once the patient has been stabilised, the volvulus should be surgically reduced via a cranioventral midline laparotomy. In a ventral midline approach, the first visible structure encountered with a clockwise rotation of the stomach is the ventral leaf of the omentum. The spleen may be displaced from the left side of the abdomen to the right (ventral) side.

The aims of surgery include gastric decompression and repositioning, assessment of the abdominal organ viability, removal of necrotic tissue and gastropexy. Gastropexy (can perform incisional, tube, belt-loop and circumcostal techniques) to prevent recurrence.

Gastropexy (can perform incisional, tube, belt-loop and circumcostal techniques) to prevent recurrence

If gastric necrosis (happens in 10-37% of patients) is present (discoloured dark purple or grey/green, don't bleed when incised or feel paper thin) then a parital gastrectomy is required. Damage to the spleen via avulsion or torsion may need partial or complete splenectomy.

If gastric necrosis (happens in 10-37% of patients) is present (discoloured dark purple or grey/green, don't bleed when incised or feel paper thin) then a parital gastrectomy is required. Damage to the spleen via avulsion or torsion may need partial or complete splenectomy.