Acute Gastric Volvulus: an Uncommon and Life-Threatening Disease

Gastric volvulus is a rare and life-threatening condition that involves the abnormal rotation of the stomach around its axis by more than 180°. The association between acute gastric volvulus and atrial fibrillation with rapid ventricular response is rare with only few cases that have been reported. Our patient was an 86-year-old female who presented with upper abdominal pain, distension, nausea, and shortness of breath. Clinical and laboratory workup revealed acute gastric volvulus with diaphragmatic hernia. On presentation, she was also in atrial fibrillation with rapid ventricular response. She was successfully treated by laparotomy with reduction of the gastric volvulus and repair of the diaphragmatic hernia, with significant improvement.

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Acute mesenteroaxial gastric volvulus on computed tomography

South African Journal of Radiology ◽

10.4102/sajr.v17i1.206 ◽

2013 ◽

Vol 17 (1) ◽

pp. 21-23 ◽

Cited By ~ 2

Author(s):

Aadil Ahmed

Keyword(s):

Computed Tomography ◽

Intestinal Obstruction ◽

Gastric Volvulus ◽

Different Types ◽

Acute Gastric Volvulus ◽

Life Threatening ◽

Ct Features

Acute gastric volvulus is a rare, but potentially life-threatening, cause of upper gastro-intestinal obstruction. The diagnosis can prove clinically challenging, and hence there is increased reliance on imaging. There are different types of gastric volvulus, with the variant presented in our case being the less commonly encountered mesenteroaxial gastric volvulus. Some of the CT features of gastric volvulus are described, and the usefulness of CT in assisting with the diagnosis is highlighted.

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An unusual presentation of acute gastric volvulus in the elderly patient: a case report and literature review

International Surgery Journal ◽

10.18203/2349-2902.isj20203282 ◽

2020 ◽

Vol 7 (8) ◽

pp. 2796

Author(s):

Aditya Prasad Padhy ◽

Inturi Pranay ◽

Sarvesh Biradar

Keyword(s):

Gastric Volvulus ◽

Longitudinal Axis ◽

The Elderly ◽

Radiologic Diagnosis ◽

Clinical Presentations ◽

Acute Gastric Volvulus ◽

Life Threatening ◽

History Of ◽

Timely Fashion ◽

High Level

Gastric volvulus is nothing but the torsion of stomach in thoracic cavity by more than 1800 along its transverse or longitudinal axis. A very rare case occurring both in male and female. The term first described by Berti after doing an autopsy of a female, in 1886. We found a case of 65 years old male with history of dyspepsia since, 1 year with history of vomiting and pain abdomen since, 1 day. On evaluation, clinically gurgling sound heard on left side chest and with investigations like USG and CT whole abdomen, we came to know about mesentrico axial volvulus which is more common in children. Acute gastric volvulus cases have high mortality rate also requires emergency surgery. Gastric volvulus is very rare with variable and non-specific clinical presentations, hence high level of suspicion for radiologic diagnosis may require. Acute gastric volvulus is a potentially life-threatening occurrence with a good outcome when treated in a timely fashion. Chronic volvulus may be more difficult to recognize. Timely diagnosis with proper treatment can potentially decreases morbidity and mortality of the patient.

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Acute gastric volvulus: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20180846 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1137 ◽

Cited By ~ 1

Author(s):

Alaa Sedik ◽

Salwa Elhoushy

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Epigastric Pain ◽

Gastric Volvulus ◽

Abdominal Distension ◽

Aggressive Management ◽

Threatening Condition ◽

Acute Gastric Volvulus ◽

Life Threatening ◽

Severe Epigastric Pain

Acute gastric volvulus is a rare, life-threatening condition, but its intermittent nature and vague symptoms may make diagnosis difficult. Imaging is usually only diagnostic if carried out when patients are symptomatic. In the acute scenario, severe epigastric pain, retching with or without vomiting and difficulty or inability to pass nasogastric tube, constitute the Borchardt ’s triad that may be diagnostic. Herein, author reported a case that presented lately to the emergency department in shock with severe abdominal pain, abdominal distension and vomiting. Unfortunately, she died before surgery. Acute gastric volvulus is a surgical emergency requiring early diagnosis and aggressive management, as a delay results into complications like gangrene and perforation which substantially increase the morbidity and mortality in these patients.

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Splenic laceration with a twist: a lesson learnt from gastric volvulus

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221588974 ◽

2012 ◽

Vol 94 (2) ◽

pp. e88-e89

Author(s):

C Warren ◽

W Wallace ◽

WJ Campbell

Keyword(s):

Rare Case ◽

Gastric Volvulus ◽

Diagnosis And Management ◽

Acute Gastric Volvulus ◽

Life Threatening ◽

Prompt Diagnosis

Acute gastric volvulus is an uncommon entity that requires prompt diagnosis and management to prevent potential life threatening complications. We present a rare case of splenic laceration secondary to acute gastric volvulus.

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Acute gastric volvulus: case report and review of the literature

CJEM ◽

10.1017/s1481803500004206 ◽

1999 ◽

Vol 1 (03) ◽

pp. 200-203 ◽

Cited By ~ 16

Author(s):

William E. Sevcik ◽

Ivan P. Steiner

Keyword(s):

Gastric Volvulus ◽

Signs And Symptoms ◽

Illustrative Case ◽

Emergency Physicians ◽

Review Of The Literature ◽

Gastrointestinal Obstruction ◽

Acute Gastric Volvulus ◽

Life Threatening ◽

High Index Of Suspicion ◽

Upper Gastrointestinal

ABSTRACT: Gastric volvulus is a rare but potentially life-threatening cause of upper gastrointestinal obstruction. Emergency physicians must maintain a high index of suspicion in patients who present with signs and symptoms suggesting foregut occlusion. We report an illustrative case and review the pathogenesis, classification, diagnosis and treatment of this rare entity.

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Acute Gastric Volvulus Causing Splenic Avulsion and Hemoperitoneum

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/2961063 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Yana Cavanagh ◽

Neal Carlin ◽

Ruhin Yuridullah ◽

Sohail Shaikh

Keyword(s):

Nasogastric Tube ◽

Complete Resolution ◽

Gastric Volvulus ◽

Outlet Obstruction ◽

Endoscopic Evaluation ◽

Radiographic Findings ◽

Acute Gastric Volvulus ◽

Life Threatening ◽

Initial Imaging ◽

High Index Of Suspicion

Gastric volvulus is an abnormal, potentially life-threatening, torsion of the stomach. The presence of complications such as hemoperitoneum increases the diagnostic urgency; however it can also mask the presentation of gastric volvulus. We encountered a 66-year-old female who presented with symptomatic gastric outlet obstruction and was found to have hemoperitoneum and splenic avulsion on imaging. In our case, hemoperitoneum was a clinical red herring as initial imaging concentrated on the presence of hemoperitoneum and was nondiagnostic of gastric volvulus. Interestingly, our patient experienced complete resolution of her presenting symptomatology following placement of a nasogastric tube. Furthermore, endoscopic evaluation revealed no overt pathology to explain outlet obstruction. In light of these findings, gastric torsion was strongly suspected. A repeat CT scan was confirmatory, elucidated reduction of the stomach to its anatomic position, retroactively diagnosing a gastric volvulus. This case is unusual in its presentation and setting. The patient presented with two rare complications of gastric volvulus, hemoperitoneum and splenic avulsion. Additionally, ten years prior to this presentation the patient had a temporary gastrostomy tube. Gastropexy with a gastrostomy is the treatment for gastric volvulus and should have been preventative of her presentation with torsion. Furthermore, the gastric volvulus was not initially recognized radiographically due to the presence of masking radiographic findings. This case serves to highlight the utility of clinical acumen and maintain a high index of suspicion for gastric volvulus in all cases presenting with Borchardt’s triad.

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A case of acute gastric volvulus due to diaphragmatic hernia in an adult with kyphoscoliosis

International Surgery Journal ◽

10.18203/2349-2902.isj20191916 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1809

Author(s):

Namvir Meshram ◽

Minakshi Gadhire ◽

Vineet Kumar

Keyword(s):

Abdominal Pain ◽

Diaphragmatic Hernia ◽

Nasogastric Tube ◽

Gastric Volvulus ◽

Postoperative Course ◽

X Ray ◽

Upper Gi ◽

Threatening Condition ◽

Acute Gastric Volvulus ◽

Life Threatening

Acute gastric volvulus on diaphragmatic hernia is a rare and life-threatening condition, which is seen mostly in fifth decade of life. Presented with vague symptoms of abdominal pain mostly epigastric in nature, retching, may or may not be associated with vomiting, hematemesis, sometime difficult to pass nasogastric tube (Borchardt triad’s). Hereby we report a case of 48 year old male with known case of kyphoscoliosis who came with hematemesis and vomiting only; on investigation chest with abdomen X ray, USG, upper GI scopy and CT chest with abdomen, suggestive of gastric volvulus with diaphragmatic hernia and kyphoscoliosis. Patient was operated; as in acute gastric volvulus delay may result in complication like perforation and gangrene which can lead to increase morbidity and mortality in this patient; derotation of stomach done and diaphragmatic defect repaired with meshplasty, gastropexy with gastrostomy done. Postoperative course was uneventful.

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