Abstract
A 91-year-old woman presented to the medical admissions unit complaining of repeated episodes of vomiting and consequent dehydration. The patient had first presented with vomiting 8 years earlier, at which time gastritis had been diagnosed clinically and treated with oral proton-pump inhibitors. Three months before this admission, she had undergone an outpatient gastroscopy examination, which revealed extrinsic compression at the mid-stomach, giving the impression of a large hiatus hernia with diaphragmatic constriction (Figure 1). The endoscopist was unable to pass the scope beyond the pylorus and raised the possibility of a torsion or rotation. Figure 1. Endsocopic image demonstrating the circumferential extrinsic compression at the mid-stomach, assumed initially to be due to a hiatus hernia. On this admission, clinical examination revealed a large …
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