Organo-axial volvulus of the stomach with diaphragmatic eventration

Abstract

Gastric volvulus occurs when the stomach rotates about its longitudinal axis (organo-axial volvulus), or about an axis joining the lesser and greater curvatures (mesentero-axial volvulus). Primary gastric volvulus, making up one third of cases, occurs when the stabilizing ligaments are too lax as a result of congenital or acquired causes. Secondary gastric volvulus, making up the remainder of cases, occurs in association with a paraesophageal hernia or other congenital or acquired diaphragmatic defects. While gastric volvulus may occur acutely, especially in children, it may not be clinically apparent and discovered incidentally. The authors present a case of chronic organo-axial volvulus of the stomach secondary to left hemidiaphragmatic eventration with a review of the relevant literature.

Figure 1.

Chest PA (Figure 1A) and left lateral view (Figure 1B) of the case. A large gas filled structure with air-fluid level is noted in the left subphrenic space on lower thoracic cavity. The heart is displaced to the right side.

Figure 2.

Upper gastrointestinal series showing organo-axial type of volvulus. It shows reversal of the greater and lesser curvatures with two air-fluid levels, typical features of organo-axial volvulus.