Vólvulo gástrico, causa infrecuente de dolor abdominal agudo

espanolEl volvulo gastrico (VG) se caracteriza por la rotacion anormal de una porcion del estomago alrededor de un eje -horizontal o vertical- que puede ocasionar obstruccion, compromiso vascular e incluso estrangulacion, pudiendo evolucionar a necrosis e incluso perforacion. Se puede clasificar de acuerdo a su etiologia, en primario o secundario, de acuerdo a su anatomia en organo-axial o mesenterico-axial y de acuerdo a su presentacion en cronico o agudo. Ambos tipos de volvulos requieren de tratamiento, sin embargo, a pesar de que el tratamiento clasico ha sido la cirugia abierta, no existe un tratamiento estandar, ni consenso sobre la alternativa de eleccion en la actualidad. Las tecnicas de minima invasion, bien sean endoscopicas o laparoscopicas, deben ser consideradas en los pacientes de edad avanzada y alto riesgo quirurgico en quienes se busca disminuir la morbilidad y mortalidad perioperatoria. EnglishGastric volvulus (GV) is characterized by the abnormal rotation of a portion of the stomach around a horizontal or vertical axis that can cause obstruction, vascular disorder and even strangulation, and may evolve into necrosis or even perforation. It can be classified according to its aetiology into primary or secondary GV, according to its anatomy into axial organ or into axial mesenteric GV, and according to its presentation into chronic or acute GV. Both types of volvulus require treatment; however, in spite of the classic treatment being open surgery, there is no standard treatment, nor is there consensus on the alternative of choice at present. Minimally invasion techniques, whether endoscopic or laparoscopic, should be considered in patients of advanced age or high surgical risk, where what is sought is a reduction in perioperative morbidity and mortality.