Presentation
New-onset epigastric pain.
Patient Data
Age: 85 years
Gender: Female
From the case:
Gastric emphysema due to strangulation
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Nasogastric tube tip is in the antrum.
Case Discussion
The CT study shows gastric pneumatosis indicative of gastric wall ischemia, in this case a consequence of incarceration and strangulation due to volvulus of the gastroduodenal junction inside an epigastric hernia.
The patient was promptly operated on. Duodenal volvulus was verified. The stomach was partially resected and the hernia was repaired. Splenectomy had to be carried out as well, due to bleeding after the stomach was released from the hernia sac.