Three patients were presented for treatment of gastric dilatation–volvulus (GDV).
The entire abdomen is clipped and aseptically prepared. An incision is made from the xiphoid process to the pubis to allow for adequate exploratory laparotomy and gain the proper exposure to facilitate stomach derotation. Once the abdomen is open, it is immediately clear that the omentum is draped over the ventral aspect of the stomach; this is the pathognomonic sign for GDV. The surgeon takes a quick glance at the serosal surface of the stomach to help determine if there are any nonviable areas and reaches to identify the pylorus and pull it from left to right. In this first case, the patient had a 180° volvulus that was easily reduced with this manipulation.
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