Aetiology
Gastric dilatation and volvulus is an abnormal accumulation of gastric gas resulting in dilatation, which can be further complicated by the rotation of the stomach (volvulus) of the stomach around its mesenteric axis. This incorrect positioning and rotation of the stomach around its axis causes obstruction to inflow and outflow, resulting in the rapid accumulation of intraluminal fluid and gas. It is thought that the stomach rotates first, and then becomes distended with gas.
As the patient becomes uncomfortable, aerophagia can result in further gas accumulation within the stomach. Gastric distension results in increased gastric pressure, and compression of the diaphragm and great vessels, including the caudal vena cava. Inadequate venous return to the right heart subsequently decreases cardiac preload (the volume of blood returning to the heart), with a decrease in cardiac output. Decreased perfusion to the gastric mucosa and serosa also results in the release of inflammatory cytokines. There are a variety of pathophysiological changes which take place within the body and these changes are responsible for the high mortality rate which is associated with gastric dilatation and torsion. The course of events which lead to a GDV as still not fully understood.
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