165:, a retrocardiac, gas-filled viscus may be seen in cases of intrathoracic stomach, which confirms the diagnosis. Plain abdominal radiography reveals a massively distended viscus in the upper abdomen. In organoaxial volvulus, plain films may show a horizontally oriented stomach with a single air-fluid level and a paucity of distal gas. In mesenteroaxial volvulus, plain abdominal radiographic findings include a spherical stomach on supine images and 2 air-fluid levels on erect images, with the antrum positioned superior to the fundus.
230:
may be helpful in the diagnosis of gastric volvulus. When this procedure reveals distortion of the gastric anatomy with difficulty intubating the stomach or pylorus, it can be highly suggestive of gastric volvulus. In the late stage of gastric volvulus, strangulation of the blood supply can result in
112:
of the stomach. This is the most common type of gastric volvulus, occurring in approximately 59% of cases, and it is usually associated with diaphragmatic defects. Strangulation and necrosis commonly occur with organoaxial gastric volvulus and have been reported in 5–28% of cases. The key imaging
59:
by more than 180 degrees with obstruction of the flow of material through the stomach, variable loss of blood supply and possible tissue death. The twisting can occur around the long axis of the stomach: this is called organoaxial or around the axis perpendicular to this, called mesenteroaxial.
121:
The mesenteroaxial axis bisects the lesser and greater curvatures. The antrum rotates anteriorly and superiorly so that the posterior surface of the stomach lies anteriorly. The rotation is usually incomplete and occurs intermittently. Vascular compromise is uncommon. This cause comprises
144:
Gastric volvulus of unknown cause comprises two thirds of cases and is presumably due to abnormal laxity of the gastrosplenic, gastroduodenal, gastrophrenic, and gastrohepatic ligaments. Type 1 gastric volvulus is more common in adults but has been reported in children.
195:
Often performed for an evaluation of acute abdominal pain, a computed tomography (CT) scan can offer immediate diagnosis by showing two bubbles with a transition line. Proponents of CT scanning in the diagnosis of gastric volvulus report several benefits, including:
130:
The combined type of gastric volvulus is a rare form in which the stomach twists mesentericoaxially and organoaxially. This type of gastric volvulus makes up the remainder of cases and is usually observed in patients with chronic volvulus.
238:
The nonoperative mortality rate for gastric volvulus is reportedly as high as 80%. Historically, mortality rates of 30–50% have been reported for acute gastric volvulus, with the major cause of death being strangulation, which can lead to
347:
335:
192:) are sensitive and specific if performed with the stomach in the "twisted" state and may show an upside-down stomach. Contrast studies have been reported to have a diagnostic yield in 81–84% of patients.
153:
Type 2 gastric volvulus is found in one third of patients and is usually associated with congenital or acquired abnormalities that result in abnormal mobility of the stomach.
1284:
87:
and reportedly occurs in 70% of cases. Sometimes severe pain at the top of left shoulder, this may be due to internal bleeding irritating the diaphragm upon respiration.
122:
approximately 29% of cases of gastric volvulus. The key imaging feature of mesenteroaxial volvulus is that the antrum is above the gastroesophageal junction.
462:
247:. With advances in diagnosis and management, the mortality rate from acute gastric volvulus is 15–20% and that for chronic gastric volvulus is 0–13%.
966:
302:
561:
600:
455:
828:
740:
480:
100:
In an organoaxial gastric volvulus, the stomach rotates around an axis that connects the gastroesophageal junction and the
1041:
448:
1713:
1560:
60:
Obstruction is more likely in organoaxial twisting than with mesenteroaxial while the latter is more associated with
113:
feature of organoaxial volvulus is that the greater curvature is located above the lesser curvature of the stomach.
1458:
1599:
1211:
1194:
699:
694:
571:
1453:
1409:
1303:
1125:
724:
71:
The classic triad (Borchardt's Triad) of gastric volvulus, described by
Borchardt in 1904, consists of severe
1664:
1510:
420:
Schaefer D, Nikoomenesh P, Moore C (1997). "Gastric volvulus: an old disease process with some new twists".
1419:
938:
546:
244:
633:
1750:
999:
928:
529:
173:
The diagnosis of gastric volvulus is usually based on barium studies; however, some authors recommend
1272:
1228:
1181:
987:
605:
1618:
1298:
933:
891:
704:
579:
566:
536:
507:
362:
267:
Carter, R; Brewer LA, 3rd; Hinshaw, DB (July 1980). "Acute gastric volvulus. A study of 25 cases".
204:
1755:
1543:
1320:
1061:
853:
512:
1623:
1347:
1330:
714:
590:
541:
502:
472:
1555:
1474:
1463:
1424:
1352:
655:
296:
1594:
1538:
1359:
1255:
838:
833:
667:
585:
551:
181:
200:
the ability to rapidly diagnose the condition based on a few coronal reconstructed images,
8:
1688:
1498:
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1374:
1335:
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1103:
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1073:
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823:
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174:
1700:
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1369:
1004:
896:
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628:
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356:
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1032:
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35:
1725:
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1364:
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942:
901:
674:
402:
276:
162:
109:
84:
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1613:
1479:
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1379:
1250:
1115:
1051:
953:
872:
863:
813:
753:
638:
615:
367:
72:
40:
405:
1720:
1635:
1189:
1162:
1027:
962:
958:
848:
818:
378:
105:
1744:
1653:
1606:
1399:
1342:
1325:
1237:
982:
809:
684:
650:
595:
211:
65:
1528:
1440:
1313:
1216:
1167:
1152:
1147:
1143:
1056:
881:
797:
689:
679:
645:
189:
433:
288:
1708:
1470:
1448:
1279:
1199:
843:
744:
497:
327:
1484:
1157:
1135:
780:
719:
1434:
1404:
1267:
1245:
1098:
949:
923:
785:
775:
662:
623:
556:
397:
227:
1068:
1046:
758:
240:
232:
80:
76:
61:
1120:
886:
790:
762:
101:
56:
1586:
1204:
1090:
339:
185:
210:
the detection of predisposing factors (i.e., diaphragmatic or
1036:
766:
470:
203:
the ability to detect the presence or absence of gastric
419:
266:
64:. About one third of the cases are associated with a
317:
177:(CT) scanning as the imaging modality of choice.
1742:
456:
562:Esophagogastric junction outflow obstruction
301:: CS1 maint: numeric names: authors list (
262:
260:
217:the exclusion of other abdominal pathology.
601:Esophageal intramural pseudodiverticulosis
463:
449:
257:
1743:
116:
1585:
829:Small intestinal bacterial overgrowth
444:
108:rotates in opposite direction to the
79:(due to sour taste in mouth) without
55:is a twisting of all or part of the
168:
95:
13:
14:
1767:
1714:Spontaneous bacterial peritonitis
1561:Exocrine pancreatic insufficiency
313:
235:ulceration or mucosal fissuring.
90:
1459:Secondary sclerosing cholangitis
125:
700:Gastric antral vascular ectasia
695:Portal hypertensive gastropathy
572:Gastroesophageal reflux disease
1454:Primary sclerosing cholangitis
1304:Hepatic veno-occlusive disease
1126:Solitary rectal ulcer syndrome
1:
1511:Sphincter of Oddi dysfunction
250:
182:contrast radiographic studies
1420:Postcholecystectomy syndrome
939:Intestinal pseudoobstruction
547:Esophageal motility disorder
281:10.1016/0002-9610(80)90424-9
226:Upper gastrointestinal (GI)
221:
180:Upper gastrointestinal (GI)
156:
7:
269:American Journal of Surgery
10:
1772:
1405:Gallstone / Cholelithiasis
929:Functional colonic disease
725:Zollinger–Ellison syndrome
1699:
1578:
1519:
1433:
1390:
1236:
1227:
1180:
1134:
1089:
975:
862:
752:
739:
614:
606:Acute esophageal necrosis
488:
479:
388:
321:
148:
139:
68:. Treatment is surgical.
34:
26:
21:
705:Gastric dumping syndrome
580:Laryngopharyngeal reflux
567:Diffuse esophageal spasm
134:
1321:Alcoholic liver disease
854:Bile acid malabsorption
798:Peptic (duodenal) ulcer
1331:Hepatic encephalopathy
715:Buried bumper syndrome
646:Peptic (gastric) ulcer
530:Mallory–Weiss syndrome
473:human digestive system
83:, inability to pass a
1556:Pancreatic pseudocyst
1425:Porcelain gallbladder
537:Zenker's diverticulum
1360:Hepatorenal syndrome
1299:Budd–Chiari syndrome
1256:Autoimmune hepatitis
1081:Intestinal adhesions
839:Short bowel syndrome
668:Functional dyspepsia
586:Esophageal stricture
552:Nutcracker esophagus
1499:Choledocholithiasis
1370:Metabolic disorders
1336:Acute liver failure
1309:Portal hypertension
1261:Alcoholic hepatitis
1104:Radiation proctitis
1023:Mesenteric ischemia
995:Gastroenterocolitis
824:Blind loop syndrome
634:Ménétrier's disease
542:Barrett's esophagus
175:computed tomography
117:Mesenteroaxial type
53:volvulus of stomach
30:Volvulus of stomach
1674:Undefined location
1665:Grynfeltt–Lesshaft
1566:Pancreatic fistula
1549:Pancreatic abscess
1504:Biliary dyskinesia
1475:Mirizzi's syndrome
976:Large and/or small
656:Dieulafoy's lesion
525:Boerhaave syndrome
422:Gastroenterologist
389:External resources
1751:Stomach disorders
1738:
1737:
1734:
1733:
1574:
1573:
1176:
1175:
1033:Bowel obstruction
735:
734:
415:
414:
163:chest radiography
46:
45:
16:Medical condition
1763:
1726:Pneumoperitoneum
1583:
1582:
1493:Common bile duct
1375:Wilson's disease
1365:Peliosis hepatis
1234:
1233:
1111:Proctalgia fugax
1018:Abdominal angina
943:Ogilvie syndrome
892:Pseudomembranous
750:
749:
710:Gastric volvulus
675:Pyloric stenosis
486:
485:
471:Diseases of the
465:
458:
451:
442:
441:
437:
319:
318:
307:
306:
300:
292:
264:
169:Upper GI studies
96:Organoaxial type
85:nasogastric tube
49:Gastric volvulus
22:Gastric volvulus
19:
18:
1771:
1770:
1766:
1765:
1764:
1762:
1761:
1760:
1741:
1740:
1739:
1730:
1695:
1684:Internal hernia
1570:
1515:
1480:Biliary fistula
1438:
1429:
1415:Adenomyomatosis
1410:Cholesterolosis
1386:
1380:Hemochromatosis
1251:Viral hepatitis
1223:
1172:
1130:
1116:Rectal prolapse
1085:
1052:Fecal impaction
1042:Intussusception
1005:Crohn's disease
971:
954:Toxic megacolon
866:
864:Large intestine
858:
803:Curling's ulcer
756:
754:Small intestine
743:
731:
639:Gastroenteritis
610:
475:
469:
416:
411:
410:
384:
383:
330:
316:
311:
310:
294:
293:
265:
258:
253:
224:
171:
159:
151:
142:
137:
128:
119:
98:
93:
73:epigastric pain
41:General surgery
17:
12:
11:
5:
1769:
1759:
1758:
1756:Medical triads
1753:
1736:
1735:
1732:
1731:
1729:
1728:
1723:
1721:Hemoperitoneum
1718:
1717:
1716:
1705:
1703:
1697:
1696:
1694:
1693:
1692:
1691:
1686:
1681:
1670:
1669:
1668:
1667:
1662:
1649:
1648:
1643:
1638:
1633:
1628:
1627:
1626:
1621:
1610:
1609:
1604:
1603:
1602:
1591:
1589:
1580:
1576:
1575:
1572:
1571:
1569:
1568:
1563:
1558:
1553:
1552:
1551:
1546:
1541:
1536:
1525:
1523:
1517:
1516:
1514:
1513:
1508:
1507:
1506:
1501:
1488:
1487:
1482:
1477:
1468:
1467:
1466:
1461:
1456:
1445:
1443:
1431:
1430:
1428:
1427:
1422:
1417:
1412:
1407:
1402:
1396:
1394:
1388:
1387:
1385:
1384:
1383:
1382:
1377:
1367:
1362:
1357:
1356:
1355:
1350:
1340:
1339:
1338:
1333:
1323:
1318:
1317:
1316:
1311:
1306:
1301:
1289:
1288:
1287:
1277:
1276:
1275:
1265:
1264:
1263:
1258:
1253:
1242:
1240:
1231:
1225:
1224:
1222:
1221:
1220:
1219:
1209:
1208:
1207:
1202:
1192:
1190:Blood in stool
1186:
1184:
1178:
1177:
1174:
1173:
1171:
1170:
1165:
1163:Anal dysplasia
1160:
1155:
1150:
1140:
1138:
1132:
1131:
1129:
1128:
1123:
1118:
1113:
1108:
1107:
1106:
1095:
1093:
1087:
1086:
1084:
1083:
1078:
1077:
1076:
1066:
1065:
1064:
1054:
1049:
1044:
1039:
1030:
1028:Angiodysplasia
1025:
1020:
1009:
1008:
1007:
997:
992:
991:
990:
979:
977:
973:
972:
970:
969:
963:Diverticulosis
959:Diverticulitis
956:
947:
946:
945:
936:
926:
921:
920:
919:
914:
909:
904:
899:
894:
884:
878:
876:
860:
859:
857:
856:
851:
849:Milroy disease
846:
841:
836:
831:
826:
821:
819:Tropical sprue
816:
807:
806:
805:
795:
794:
793:
788:
783:
772:
770:
747:
741:Lower GI tract
737:
736:
733:
732:
730:
729:
728:
727:
717:
712:
707:
702:
697:
692:
687:
682:
677:
672:
671:
670:
660:
659:
658:
653:
643:
642:
641:
636:
631:
620:
618:
612:
611:
609:
608:
603:
598:
593:
588:
583:
577:
576:
575:
569:
564:
559:
554:
544:
539:
534:
533:
532:
527:
517:
516:
515:
510:
505:
494:
492:
483:
481:Upper GI tract
477:
476:
468:
467:
460:
453:
445:
439:
438:
413:
412:
409:
408:
393:
392:
390:
386:
385:
382:
381:
370:
359:
344:
331:
326:
325:
323:
322:Classification
315:
314:External links
312:
309:
308:
255:
254:
252:
249:
223:
220:
219:
218:
215:
212:hiatal hernias
208:
201:
170:
167:
158:
155:
150:
147:
141:
138:
136:
133:
127:
124:
118:
115:
97:
94:
92:
91:Classification
89:
44:
43:
38:
32:
31:
28:
24:
23:
15:
9:
6:
4:
3:
2:
1768:
1757:
1754:
1752:
1749:
1748:
1746:
1727:
1724:
1722:
1719:
1715:
1712:
1711:
1710:
1707:
1706:
1704:
1702:
1698:
1690:
1687:
1685:
1682:
1680:
1677:
1676:
1675:
1672:
1671:
1666:
1663:
1661:
1658:
1657:
1656:
1655:
1651:
1650:
1647:
1644:
1642:
1639:
1637:
1634:
1632:
1629:
1625:
1622:
1620:
1617:
1616:
1615:
1612:
1611:
1608:
1605:
1601:
1598:
1597:
1596:
1595:Diaphragmatic
1593:
1592:
1590:
1588:
1584:
1581:
1577:
1567:
1564:
1562:
1559:
1557:
1554:
1550:
1547:
1545:
1542:
1540:
1537:
1535:
1532:
1531:
1530:
1527:
1526:
1524:
1522:
1518:
1512:
1509:
1505:
1502:
1500:
1497:
1496:
1495:
1494:
1490:
1489:
1486:
1483:
1481:
1478:
1476:
1472:
1469:
1465:
1462:
1460:
1457:
1455:
1452:
1451:
1450:
1447:
1446:
1444:
1442:
1436:
1432:
1426:
1423:
1421:
1418:
1416:
1413:
1411:
1408:
1406:
1403:
1401:
1400:Cholecystitis
1398:
1397:
1395:
1393:
1389:
1381:
1378:
1376:
1373:
1372:
1371:
1368:
1366:
1363:
1361:
1358:
1354:
1351:
1349:
1346:
1345:
1344:
1343:Liver abscess
1341:
1337:
1334:
1332:
1329:
1328:
1327:
1326:Liver failure
1324:
1322:
1319:
1315:
1312:
1310:
1307:
1305:
1302:
1300:
1297:
1296:
1295:
1294:
1290:
1286:
1283:
1282:
1281:
1278:
1274:
1271:
1270:
1269:
1266:
1262:
1259:
1257:
1254:
1252:
1249:
1248:
1247:
1244:
1243:
1241:
1239:
1235:
1232:
1230:
1226:
1218:
1215:
1214:
1213:
1210:
1206:
1203:
1201:
1198:
1197:
1196:
1193:
1191:
1188:
1187:
1185:
1183:
1179:
1169:
1166:
1164:
1161:
1159:
1156:
1154:
1151:
1149:
1145:
1142:
1141:
1139:
1137:
1133:
1127:
1124:
1122:
1119:
1117:
1114:
1112:
1109:
1105:
1102:
1101:
1100:
1097:
1096:
1094:
1092:
1088:
1082:
1079:
1075:
1072:
1071:
1070:
1067:
1063:
1060:
1059:
1058:
1055:
1053:
1050:
1048:
1045:
1043:
1040:
1038:
1034:
1031:
1029:
1026:
1024:
1021:
1019:
1015:
1014:
1010:
1006:
1003:
1002:
1001:
998:
996:
993:
989:
986:
985:
984:
983:Enterocolitis
981:
980:
978:
974:
968:
964:
960:
957:
955:
951:
948:
944:
940:
937:
935:
932:
931:
930:
927:
925:
922:
918:
915:
913:
910:
908:
905:
903:
900:
898:
895:
893:
890:
889:
888:
885:
883:
880:
879:
877:
874:
870:
865:
861:
855:
852:
850:
847:
845:
842:
840:
837:
835:
832:
830:
827:
825:
822:
820:
817:
815:
811:
810:Malabsorption
808:
804:
801:
800:
799:
796:
792:
789:
787:
784:
782:
779:
778:
777:
774:
773:
771:
768:
764:
760:
755:
751:
748:
746:
742:
738:
726:
723:
722:
721:
718:
716:
713:
711:
708:
706:
703:
701:
698:
696:
693:
691:
688:
686:
685:Gastroparesis
683:
681:
678:
676:
673:
669:
666:
665:
664:
661:
657:
654:
652:
651:Cushing ulcer
649:
648:
647:
644:
640:
637:
635:
632:
630:
627:
626:
625:
622:
621:
619:
617:
613:
607:
604:
602:
599:
597:
596:Megaesophagus
594:
592:
589:
587:
584:
581:
578:
573:
570:
568:
565:
563:
560:
558:
555:
553:
550:
549:
548:
545:
543:
540:
538:
535:
531:
528:
526:
523:
522:
521:
518:
514:
511:
509:
506:
504:
501:
500:
499:
496:
495:
493:
491:
487:
484:
482:
478:
474:
466:
461:
459:
454:
452:
447:
446:
443:
435:
431:
427:
423:
418:
417:
407:
404:
400:
399:
395:
394:
391:
387:
380:
376:
375:
371:
369:
365:
364:
360:
358:
354:
353:
349:
345:
342:
341:
337:
333:
332:
329:
324:
320:
304:
298:
290:
286:
282:
278:
275:(1): 99–106.
274:
270:
263:
261:
256:
248:
246:
242:
236:
234:
229:
216:
213:
209:
207:and free air,
206:
202:
199:
198:
197:
193:
191:
187:
183:
178:
176:
166:
164:
154:
146:
132:
126:Combined type
123:
114:
111:
107:
103:
88:
86:
82:
78:
74:
69:
67:
66:hiatus hernia
63:
58:
54:
50:
42:
39:
37:
33:
29:
25:
20:
1673:
1652:
1529:Pancreatitis
1491:
1441:biliary tree
1314:Nutmeg liver
1291:
1217:Hematochezia
1168:Pruritus ani
1153:Anal abscess
1148:Anal fistula
1144:Anal fissure
1057:Constipation
1011:
882:Appendicitis
709:
690:Gastroptosis
680:Achlorhydria
519:
508:Eosinophilic
425:
421:
396:
372:
361:
346:
334:
297:cite journal
272:
268:
237:
231:progressive
225:
194:
190:Gastrografin
179:
172:
160:
152:
143:
129:
120:
99:
70:
52:
48:
47:
1709:Peritonitis
1471:Cholestasis
1449:Cholangitis
1392:Gallbladder
1280:Fatty liver
1200:Hematemesis
1182:GI bleeding
988:Necrotizing
917:Lymphocytic
912:Collagenous
907:Microscopic
844:Steatorrhea
745:Enteropathy
591:Inlet patch
513:Herpetiform
498:Esophagitis
428:(1): 41–5.
245:perforation
205:pneumatosis
27:Other names
1745:Categories
1701:Peritoneal
1679:Incisional
1600:Congenital
1544:Hereditary
1521:Pancreatic
1485:Haemobilia
1158:Hemorrhoid
1136:Anal canal
1074:Infectious
1062:Functional
897:Ulcerative
781:Duodenitis
720:Gastrinoma
374:DiseasesDB
251:References
1689:Richter's
1646:Spigelian
1641:Obturator
1631:Umbilical
1464:Ascending
1435:Bile duct
1268:Cirrhosis
1246:Hepatitis
1229:Accessory
1099:Proctitis
950:Megacolon
924:Dysentery
834:Whipple's
786:Jejunitis
776:Enteritis
663:Dyspepsia
624:Gastritis
557:Achalasia
490:Esophagus
406:radio/296
398:eMedicine
228:endoscopy
222:Endoscopy
157:Diagnosis
36:Specialty
1619:Indirect
1614:Inguinal
1348:Pyogenic
1293:Vascular
1069:Diarrhea
1047:Volvulus
1013:Vascular
952: /
941: /
902:Ischemic
869:Appendix
759:Duodenum
629:Atrophic
503:Candidal
403:med/2714
241:necrosis
233:ischemic
81:vomiting
77:retching
62:ischemia
1660:Petit's
1636:Femoral
1539:Chronic
1353:Amoebic
1121:Anismus
887:Colitis
814:Coeliac
791:Ileitis
763:Jejunum
616:Stomach
520:Rupture
434:9074918
368:D013277
343:: K31.8
289:7396092
184:(using
102:pylorus
57:stomach
1654:Lumbar
1624:Direct
1607:Hiatus
1587:Hernia
1439:Other
1205:Melena
1091:Rectum
574:(GERD)
432:
357:537.89
287:
214:), and
186:barium
149:Type 2
140:Type 1
110:fundus
106:antrum
104:. The
1579:Other
1534:Acute
1285:MASLD
1238:Liver
1212:Lower
1195:Upper
1037:Ileus
873:Colon
767:Ileum
582:(LPR)
379:32054
135:Cause
967:SCAD
430:PMID
363:MeSH
352:9-CM
303:link
285:PMID
243:and
1273:PBC
1000:IBD
934:IBS
348:ICD
336:ICD
277:doi
273:140
188:or
161:On
51:or
1747::
1437:/
1035::
1016::
812::
424:.
401::
377::
366::
355::
340:10
299:}}
295:{{
283:.
271:.
259:^
75:,
1473:/
1146:/
965:/
961:/
875:)
871:/
867:(
769:)
765:/
761:/
757:(
464:e
457:t
450:v
436:.
426:5
350:-
338:-
328:D
305:)
291:.
279::
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