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511 Atypical Wheezing Cases During Infancy Due to Gastric Volvulus
  1. Ö Özdemir,
  2. G Direk,
  3. A Altunkara
  1. Pediatrics, Istanbul Medeniyet University, Göztepe Research and Training Hospital, Kadiköy, Turkey

Abstract

Background Gastric volvulus is rarely seen abnormality during childhood. Nonbilious vomiting, abdominal distension and dyspepsia are the most common presenting symptoms. Yet, it may cause reactive airway disease symptoms such as wheezing attacks, because of gastroesophageal reflux, and chronic cough in infants. Surgery after early diagnosis in gastric volvulus resolves symptoms completely and its prognosis is excellent.

Aim Here, two infants having chronic cough and recurrent wheezing attacks, unresponsive to bronchodilators, are presented.

Patients/methods Physical examination of both cases revealed about 6-month-old male patients having recurrent wheezing, tachypnea, dyspnea and subcostal retractions. Widespread ronchi and sometimes rales were heard on both lungs of the patients. Rest of the examination was normal. In their laboratory evaluations, acute phase reactants, renal and liver function tests were within normal. Immunoglobulin G, its subgroups and other immunoglobulins were found to be normal. Sweat tests were normal. High resolution computerized tomography (HRCT) demonstrated minimal mosaic pattern on both lung parenchyma. Bronchoscopy was normal in the first infant. Cranial, abdominal ultrasonography and fundus (eye) examinations showed normal findings in both patients. Cardiac examination and echocardiography were normal. Oesophago-gastro-duodenography showed gastric volvulus, organo-axial and mesentero-axial, in both infants; respectively.

Results After the surgery for gastric volvulus and gastroesophageal reflux in the first case, the symptoms entirely improved. But, the symptoms of second case resolved without surgery.

Conclusion Our cases are being reported to emphasize the necessity of thinking gastric volvulus in the differential diagnosis of atypical wheezing infant, even which it is very nadir cause.

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