Gastric Dilatation Volvulus - Pathophysiology

Pathophysiology

The stomach twists around the longitudinal axis of the digestive tract, also known as volvulus. Gas distension may occur prior to or after the stomach twists. The most common direction for rotation is clockwise, viewing the animal from behind. The stomach can rotate up to 360° in this direction and 90° counterclockwise. If the volvulus is greater than 180°, the esophagus is closed off, thereby preventing the animal from relieving the condition by belching or vomiting. The results of this distortion of normal anatomy and gas distension include hypotension (low blood pressure), decreased return of blood to the heart, ischemia (loss of blood supply) of the stomach, and shock. Pressure on the portal vein decreases blood flow to liver and decreases the ability of that organ to remove toxins and absorbed bacteria from the blood. At the other end of the stomach, the spleen may be damaged if the twisting interrupts its blood supply. If not quickly treated, bloat can lead to blood poisoning, peritonitis and death by toxic shock.

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