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. 2009:2009:bcr05.2009.1880.
doi: 10.1136/bcr.05.2009.1880. Epub 2009 Jul 12.

Gastric outlet obstruction from a caecal volvulus, herniated through epiploic foramen: a case report

Kausik Ray  1 , Claire Snowden, Kamran Khatri, Malcolm McFall
Affiliations

Gastric outlet obstruction from a caecal volvulus, herniated through epiploic foramen: a case report

Kausik Ray et al. BMJ Case Rep. 2009.

Abstract

A 55-year-old woman presented with sudden onset upper abdominal pain and vomiting. On examination she had tender epigastric mass with "succusion splash" on auscultation. Straight abdominal x ray showed a distended and displaced stomach with another gas filled viscus around it. Subsequent computed tomography suggested caecal volvulus herniated through the epiploic foramen obstructing the gastric outlet. The patient underwent reduction of the internal hernia and right hemicolectomy. Postoperative recovery was uneventful. Herniation of caecal volvulus through the epiploic foramen is a very rare condition and its presentation as a gastric outlet obstruction has not been reported before.

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Figures

Figure 1
Figure 1
Plain radiograph of abdomen showing distended stomach pushed upwards and laterally by gas filled bowel loop.
Figure 2
Figure 2
Contrast computed tomography scan suggesting caecal volvulus causing gastric outlet obstruction.
Figure 3
Figure 3
Position of the caecum between the liver and the pancreas, suggesting possible herniation through the epiploic foramen.
Figure 4
Figure 4
Diagram of perioperative findings (drawn by author)—twisted and taut mesentery of ascending colon marked with an arrow.
See this image and copyright information in PMC

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