Perforation of gastric volvulus within a giant hiatus hernia secondary to alendronate: A rare complication of bisphosphonate use

Gastric volvulus is a rare complication of diaphragmatic rupture. We report the case of an 82-year-old man who presented following an out-of-hospital cardiac arrest. Chest radiography and thoracic computed tomography revealed an acute gastric volvulus and a chronic diaphragmatic hernia containing transverse colon and abdominal viscera. He had complained of retching and associated epigastric pain prior to collapse, and had sustained a motorcycle accident approximately 60 years earlier. Insertion of a nasogastric tube was unsuccessful (completing Borchardt’s diagnostic triad) and his condition prevented both operative and endoscopic reduction of his volvulus. He died soon afterwards.

Download Full-text

Gastric volvulus and obstruction in paraesophageal hiatus hernia

The American Journal of Digestive Diseases ◽

10.1007/bf02232731 ◽

1972 ◽

Vol 17 (2) ◽

pp. 119-128 ◽

Cited By ~ 7

Author(s):

Richard R. Babb ◽

Owen C. Peck ◽

Robert W. Jamplis

Keyword(s):

Hiatus Hernia ◽

Gastric Volvulus ◽

Paraesophageal Hiatus Hernia

Download Full-text

An Unusual Case of Acute Dyspnoea: Acute Intrathoracic Gastric Volvulus with Probable Tension Gastrothorax

European Journal of Case Reports in Internal Medicine ◽

10.12890/2021_002818 ◽

2021 ◽

Author(s):

Jean Bosco Masabarakiza ◽

Lingna Zhu ◽

Yilmaz Gorur ◽

Benoît Cardos ◽

Noel Lorenzo-Villalba ◽

...

Keyword(s):

Unusual Case ◽

Rare Complication ◽

Gastric Volvulus ◽

Longitudinal Axis ◽

Gastric Distension ◽

Haemodynamic Instability ◽

Acute Dyspnoea ◽

Mediastinal Shift ◽

Acute Gastric Volvulus ◽

Tension Gastrothorax

Acute gastric volvulus is a rare complication affecting 4% of hiatal hernias. It is described as an abnormal rotation of the stomach around a transverse or longitudinal axis and can be intra-abdominal or intrathoracic. Intrathoracic gastric volvulus can lead to tension gastrothorax, which is defined as the presence of a massive gastric distension in the chest cavity causing a mediastinal shift with haemodynamic instability and a risk of cardiorespiratory arrest. We report a case of intrathoracic gastric volvulus with probable tension gastrothorax. Early diagnosis of gastrothorax with computed tomography and immediate insertion of a nasogastric tube resulted in rapid clinical improvement. Surgical intervention is the treatment of choice.

Download Full-text

Gastric volvulus following diagnostic upper gastrointestinal endoscopy: a rare complication

BMJ Case Reports ◽

10.1136/bcr-2013-202833 ◽

2014 ◽

Vol 2014 (feb10 1) ◽

pp. bcr2013202833-bcr2013202833 ◽

Cited By ~ 2

Author(s):

V. S. Karthikeyan ◽

S. C. Sistla ◽

D. Ram ◽

N. Rajkumar

Keyword(s):

Gastrointestinal Endoscopy ◽

Rare Complication ◽

Gastric Volvulus ◽

Upper Gastrointestinal Endoscopy ◽

Upper Gastrointestinal

Download Full-text

Gastric volvulus or just a large stomach? a case report with literature review of gastric volvulus and gastrointestinal pathology in acromegaly

International Surgery Journal ◽

10.18203/2349-2902.isj20200853 ◽

2020 ◽

Vol 7 (3) ◽

pp. 941

Author(s):

Jasmine J. Mui ◽

Amit Sarkar ◽

Mark Magdy

Keyword(s):

Hiatus Hernia ◽

Transverse Colon ◽

Epigastric Pain ◽

Gastric Volvulus ◽

Abdominal Distension ◽

Acromegalic Patient ◽

Ct Diagnosis ◽

Rare Finding ◽

Gastrointestinal Pathology ◽

Coffee Ground

Gastric volvulus is a surgical emergency that requires prompt recognition and management. The acromegalic patient has a number of pathophysiological factors that predispose to gastric volvulus and slow gastrointestinal (GI) transit. Authors aimed to present a case of hiatus hernia and gastric volvulus in a patient with acromegaly and review the current literature on GI anomalies in this population. A 70-year-old female presented to our institute with epigastric pain and coffee-ground vomiting on the background of acromegaly secondary to pituitary adenoma (resected in 1997). She was found to have a gastric volvulus and hiatus hernia which was repaired laparoscopically. She was discharged home but re-presented six days later with abdominal distension and vomiting. Computed tomography (CT) scan of abdomen showed recurrent gastric volvulus with involvement of the transverse colon. She underwent a laparotomy but no evidence of gastric or colonic volvulus was seen intra-operatively. The CT findings were attributed to a large stomach and coiled redundant transverse colon which could be misinterpreted as volvulus on imaging. Gastroparesis and slow bowel transit were the likely aetiology of this second presentation. This is consistent with literature reporting slow bowel transit and dolichocolon in acromegalic patients. Gastric volvulus is a rare finding associated with acromegaly. Structural anomalies in the anatomy of the acromegalic patient can make CT diagnosis challenging. This case demonstrates the need for caution when interpreting imaging in this cohort, as well as the need for further research on GI pathology associated with acromegaly.

Download Full-text