A Case of Gastric Volvulus in the Emergency Department

Abstract

Gastric Volvulus (GV) is a rare condition characterized by rotation of the stomach 180° around its axis [1]. GV can be either acute or chronic and can lead to various complications including GI obstruction and strangulation. Approximately one third of patients present with acute symptoms [2]. Acute GV is considered a surgical emergency and, if left untreated, has a high rate of mortality. Acute GV is classically characterized by Borchardt’s Triad which consists of unproductive retching, epigastric pain, and inability to pass a Nasogastric (NG) tube [3]. Postprandial vomiting can also be seen. Diagnoses are commonly made with imaging (plain radiograph or CT). In adults, GV is commonly due to diaphragmatic defects. We present a patient with a case of acute gastric volvulus in a 74-year-old female with history of hiatal hernia. The patient was diagnosed via imaging and subsequently underwent surgical reduction of the volvulus and hernia repair.