Gastric dilatation volvulus: a review

Acute gastric dilatation volvulus is a life-threatening emergency characterised by a distended stomach and rotation on its mesenteric axis (Monnet, 2003). The cause is unknown, but it is vital to promptly recognise the condition and initiate effective stabilisation (Monnet, 2003).

Another presentation is a chronic or partial gastric volvulus (Radlinsky and Fossum, 2013). This affects dogs in a more subtle way and prolonged clinical signs can be recognised (Paris et al, 2011; Radlinsky and Fossum, 2013).

This article provides theoretical and practical advice about acute gastric dilatation volvulus syndrome. It gives information about triage and recognition of the symptoms, diagnosis and haemodynamic stability before surgical intervention. Surgical considerations and postoperative care are also described, along with client education and communication about this syndrome.

Gastric dilatation volvulus is characterised by gastric distension and pyloric rotation, most commonly clockwise, between 90 and 360°. Often the spleen is displaced concomitantly to the right ventral side of the abdomen (Radlinsky and Fossum, 2013). Gastric rotation will lead to the inability to eructate (belch). Additionally, gas accumulation could come from aerophagia, bacterial fermentation of carbohydrates, diffusion from bloodstream or metabolic reactions. Meanwhile, fluid accumulates in the lumen from normal gastric secretions and from transudation secondary to venous congestion (Radlinsky and Fossum, 2013).