Changes

==Treatment==

==Treatment==

Once the patient has been stabilised, the volvulus should be surgically reduced via a cranioventral midline laparotomy. 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.

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. Gastrectomy of devitalised tissue may be required and splenic damage due to avulsion or torsion may require partial or complete splenectomy.

 

Although many types of gastropexy have been described, the belt-loop and circumcostal techniques are the most commonly used in GDV surgery. Use of tube gastrostomy is associated with a higher morbidity rate due to alteration of gastric motility and development of cellulitis around the tube.

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.

 

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.

 

===Post-operative complications===

These are wide and varied and include:

*[[Gastric Motility Disorders|Abnormal gastric motility]]

==Prognosis==

==Prognosis==