Presentation
Was fed late tonight and then fed additional snacks. Now is acting restless.
Patient Data
The stomach is distended and filled with granular food material. On the lateral projections, the pylorus is dorsally displaced and the fundus is positioned ventrally. On the v/d projection, the fundus is on the right of midline. The spleen is displaced on the lateral projections. It is not visible in its normal position on the v/d projection.The small intestine is caudally displaced and gas filled. The portion of the thorax included is normal.
Malposition of the stomach consistent with a diagnosis of gastric dilation and volvulus.
Case Discussion
A gastric dilation and volvulus is a surgical diagnosis. A 270 degree gastric rotation was corrected at surgery.
Identifying the smaller (pylorus) and larger (fundus) compartments of the stomach is key to recognizing if they are malpositioned. The pylorus is normally on the right side, and the fundus is on the left side. Multiple views of the abdomen can be helpful as gas and food is repositioned to highlight various areas. The spleen is attached to the stomach by the gastrosplenic ligament, and may also be displaced by the gastric rotation.
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