Clinical analysis of the acute volvulus after total gastrectomy in 17 cases

Objective: To investigate the clinical characteristics and principles of diagnosis and treatment of acute volvulus after total gastrectomy.Methods: Seventeen cases with acute volvulus after total gastrectomy were treated with abdominal puncture and 64 row helical CT scan.Among 16 cases treatment with operation,5 cases were treated with intestinal adhesion release combined with volvulus reduction,7 cases were treated with volvulus reduction combined with enteral decompression and 4 cases were treated with volvulus reduction,necrotic bowel resection combined with end to end anastomosis.One case was treated with conservative method.Results: Sixteen patients treated with operation discharged,and were followed up 1 to 2 years.One patient failed to timely operation,which led to massive intestinal necrosis complicated with toxic shock,multiple organ failure and die.Conclusions: Surgical treatment was the main method to treat acute volvulus after total gastrectomy.The abdominal symptoms and signs and abdominal CT should be closely observed during the course of conservative treatment.