Acute gastric volvulus: diagnosis and management over 10 years

Abstract

Background/aims: Gastric volvulus is a rare, potentially life-threatening condition, which is difficult to diagnose. This study represents a series of patients with acute gastric volvulus.

Methods: All patients presenting with acute gastric volvulus over a 10-year period were reviewed.

Results: Twenty-one patients with a median age of 66 years were identified. Acute gastric volvulus was secondary to a paraesophageal hiatus hernia in 16 patients. The major symptoms were abdominal pain, vomiting and upper gastrointestinal bleeding/anemia. The most useful investigations were barium studies and upper gastrointestinal endoscopy. Treatment was open surgery in all patients. There were no major complications and no deaths. Median hospitalization was 8 days.

Conclusion: Acute gastric volvulus is a rare condition which requires a high index of suspicion for diagnosis, which is usually based on imaging studies. The treatment is immediate surgery. Volvulus can be treated successfully by open surgery with minimal morbidity and short hospitalization.