| Abstract | | Radiographic interpretation of gastric dilatation and gastric torsion is clear by all accepted literature data. Clinical history, present clinical status of the patient and urgent surgical intervention usually gives no reasons for any doubt. Acute gastric dilatation- is a condition where the stomach is enlarged and is filled primarily with gas but retains its normal position and anatomic relationships. Thus, the pylorus is still located on the right and the fundus on the left. Gastric torsion- usually follows acute dilatation and results in varying degrees of inlet and outlet obstrucion, depending on the degree of stomach displacement. Associated clinical signs, such as attempted vomiting, abdominal distention, and shock, developed rapidly, reflecting the ischemic as well as the obstructive nature of this disorders. Major radiographic observation shows a greatly enlarged stomach filled with food, fluid and air, usually producing a mottler gray appearance as opposed to distinct air- fluid shadows. The pylorus is displaced dorsally and to the left, often accompanied by degree od splenic dislocation. The stomach often appears divided in two by a horizontally oriented soft- tissue line extending across the central stomach in lateral view: this is referred to as compartmentalization. Contrast examination is often indicated. Despite of unquestionable diagnostic approach to the gastric volvulus, we would like to preset five patiens where clinical and diagnostic background for gastric torsion was almost doubtless. We were right in four cases but wrong in fifth case. Previously described significant clinical and radiographic signs were the reason for being misled.
|