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Case Reports
. 2017 Oct 18;7(5):325-328.
doi: 10.1080/20009666.2017.1379853. eCollection 2017.

Abdominal pain with a twist: a rare presentation of acute gastric volvulus

David P Chen  1 , Saqib Walayat  1 , Imran L Balouch  1 , Daniel K Martin  1 , Teresa J Lynch  1
Affiliations
Case Reports

Abdominal pain with a twist: a rare presentation of acute gastric volvulus

David P Chen et al. J Community Hosp Intern Med Perspect. .

Abstract

Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery. However, surgery remains the main stay of treatment. Delay in diagnosis can lead to complications like mucosal ischemia, necrosis or perforation, shock, which substantially increase the morbidity and mortality.

Keywords: Acute gastric volvulus; epigastric pain; esophagogastroduodenoscopy; gastropexy; hiatal hernia.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
X-ray of the abdomen showed a large hiatal hernia with minimal bowel gas which can be seen with gastric volvulus.
Figure 2.
Figure 2.
EGD showed a large hiatal hernia. Roughly 70% of the gastric lumen was above the diaphragmatic pinch. There is a large amount of old blood, food, and feculent material in the hernia sac with malrotation.
Figure 3.
Figure 3.
CT abdomen showed organoaxial gastric volvulus with pneumatosis of the gastric wall.
See this image and copyright information in PMC

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