Published: 2021-10-28

Gastric volvulus is a rare and life-threatening abdominal pain

Raúl Omar Martínez Zarazúa, Hector Vergara Miranda, Rafael Sáenz Resendez, Cesar Adrián Sepulveda Benavides, Daniel Eduardo Saldívar Martínez


Gastric volvulus is a rare and life-threatening abdominal pain condition resulting from the stomach twisting on its own longitudinal (organo-axial) or transverse (mesentero-axial) axis. Gastric volvulus can be primary or secondary. Secondary is most commonly related to para-esophageal hernia. Gastric volvulus can have an acute or chronic presentation, the acute form presents abdominal pain with a risk of gastric ischemia with subsequent perforation. Diagnosis is made by imaging studies such as barium contrast studies in the upper digestive tract or abdominal and chest computed tomography (CT). CT of the abdomen and thorax is very useful in the diagnosis as it can demonstrate the abnormal position and gastric torsion The goal in the definitive treatment of gastric volvulus is resolution of gastric obstruction and prevention of recurrence. Performing volvulus reduction, repair of the concomitant cause (para-esophageal hernia), fundoplication and/or gastropexy to the anterior abdominal wall. Gastropexy is considered safe and effective in elderly patients with high surgical risk.


Gastric volvulus, Para-esophageal hernia, Anterior gastropexy

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Lourenço S, Pereira A, Guimarães M. Gastric Volvulus: A Complication of Hiatal Hernia. Cureus. 2020;12(10):e11123.

Dallemagne B, Quero G, Lapergola A. Treatment of giant para-esophageal hernia: pro laparoscopic approach. Hernia. 2018;22:909-19.

Light D, Links D, Griffin M. The threatened stomach: management of the acute gastric volvulus. Surg Endosc. 2016;30(5):1847-52.

Rodriguez-Garcia HA, Wright AS, Yates RB. Managing obstructive gastric volvulus: challenges and solutions. Open Access Surg. 2017;10(1):15-24.

Yates RB, Hinojosa MW, Wright AS, Pellegrini CA, Oelschlager BK. Laparoscopic gastropexy relieves symptoms of obstructed gastric volvulus in high operative risk patients. Am J Surg. 2015;209(5):875-80.

Jervis MJ, Candeias R, Duro E, Pereira LG, Caratão F. Chronic gastric volvulus-Case report of an uncommon diagnosis. Int J Surg Case Rep. 2020;66:139-42.

Longchamp G, Andres A, Abbassi Z. Gastric necrosis following a hiatal hernia: A case report. Int J Surg Case Rep. 2021;79:108-11.

Akhtar A, Siddiqui F, Sheikh A E. Gastric Volvulus: A Rare Entity Case Report and Literature Review. Cureus. 2018;10(3):e2312.

Yusaku K. An Unusual Cause of Vomiting in the Elderly. Chonnam med J vol. 2021;57(2):154-5.

Jacob CE, Lopasso FP, Zilberstein B, Bresciani CJC, Kuga R, Cecconello I et al. Gastric volvulus-a review of 38 cases. Arq Bras Cir Dig. 2009;22(2):96-100.

Nayak HK, Maurya G, Kapoor N. Delayed presentation of congenital diaphragmatic hernia presenting with intrathoracic gastric volvulus: a case report and review. BMJ Case Rep. 2012;2012:bcr2012007332.

Wissam G, El Moussaa H, Rizka SE, Assakera NC, Makhoulb ES, Chelala EH. Large para-esophageal hernia in elderly patients: Two case reports of laparoscopic posterior cruroplasty and anterior gastropexy. Int J Surg Case Rep. 2019;65:189-92.