Diagnostic difficulty in mesenteroaxial gastric volvulus— A rare cause of acute abdomen in a child

Abstract

Gastric volvulus as a cause of acute abdomen is uncommon, especially in children. This increases the likelihood of missed or delayed diagnosis leading to increased morbidity and mortality. Acute gastric volvulus is a potentially lifethreatening condition and timely diagnosis and management significantly reduces the chances of complications. We report a case of an adolescent male child, who presented to the casualty with acute abdominal pain in the epigastric region, associated with vomiting and epigastric belching and was being managed with a clinical diagnosis of acute pancreatitis. Eventration of left hemi-diaphragm was missed and gastric volvulus was not suspected in the initial differential diagnosis leading to delay in the diagnosis and management. The child was diagnosed using upper gastrointestinal barium study and was immediately operated upon with favourable outcome.