Massive Hiatal Hernia With Acute Gastric Volvulus Masked as a Suspected Food Poisoning: A Case Report

Abstract

We describe the case of a 69-year-old female who thought she had "food poisoning", which prompted her visit to the Emergency Department for evaluation of her vomiting and abdominal discomfort. Contrasted computed tomography imaging with contrast of the abdomen subsequently revealed the diagnosis of gastric volvulus, and the patient was promptly taken for surgical intervention. Gastric volvulus is rare and presents with a nonspecific history, exam, and laboratory findings. In the acute care setting, it is important to maintain a high clinical suspicion for this diagnosis, as timely imaging and intervention are crucial to decreasing patient morbidity and mortality.

Keywords: abdominal surgical emergency; acute abdominal pain; emergency abdominal surgery; gastric volvulus; hiatal hernia.

Figure 1. A computed tomography scan of the abdomen and pelvis with contrast revealed hiatal hernia with gastric volvulus and obstruction at the level of the diaphragm.