Abstract
Gastric Volvulus (GV) is a rare condition characterized by rotation of the stomach 180° around its axis [1]. GV can be either acute or chronic and can lead to various complications including GI obstruction and strangulation. Approximately one third of patients present with acute symptoms [2]. Acute GV is considered a surgical emergency and, if left untreated, has a high rate of mortality. Acute GV is classically characterized by Borchardt’s Triad which consists of unproductive retching, epigastric pain, and inability to pass a Nasogastric (NG) tube [3]. Postprandial vomiting can also be seen. Diagnoses are commonly made with imaging (plain radiograph or CT). In adults, GV is commonly due to diaphragmatic defects. We present a patient with a case of acute gastric volvulus in a 74-year-old female with history of hiatal hernia. The patient was diagnosed via imaging and subsequently underwent surgical reduction of the volvulus and hernia repair.
Highlights
Gastric volvulus was first described in an autopsy report from 1866 and first treated in 1897 [3]
Secondary volvulus can involve tumors, adhesions, or ligamentous attachments of the stomach. 80% of cases of Gastric Volvulus (GV) occur in adults, with the most common underlying cause being diaphragmatic defects such as hiatal or post-traumatic hernias
Our patient’s risk factors and presenting complaints were typical of acute gastric volvulus: an elderly female with a past medical history of chronic hiatal hernia presenting with acute abdominal pain radiating to the scapular region and with a recent history of an episode of similar pain one week prior
Summary
Gastric volvulus was first described in an autopsy report from 1866 and first treated in 1897 [3]. 80% of cases of GV occur in adults, with the most common underlying cause being diaphragmatic defects such as hiatal or post-traumatic hernias. The case being reviewed is a secondary mesenteroaxial volvulus in an elderly patient with a history of hiatal hernia.
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