Gastric volvulus - mixed organoaxial and mesoaxial

Case contributed by Dr James Sheldon

Presentation

Epigastric pain

Patient Data

Age: 42 years
Gender: Male

Opacity projected over the lower third of the right hemithorax.

The stomach is entirely intrathoracic and associated with a gastric volvulus with both organo-axial and mesentero-axial components.

The stomach is distended with that night's dinner. The pylorus lies at the expected position of the gastro-oesophageal junction. Oral contrast passes into the small bowel.

Patchy infiltrates in the lung may be due to aspiration in this setting.

Case Discussion

A gastric volvulus occurs when the stomach twists on its mesentery.

Organo-axial (rotation along the long axis) is more common than mesentero-axial (rotation along the short axis) in the adult population. The reverse is true for the paediatric population.

Imaging may reveal a completely intra-thoracic stomach. A gastric volvulus is a surgical emergency.

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Case information

rID: 26150
Case created: 2nd Dec 2013
Last edited: 8th Dec 2015
Inclusion in quiz mode: Included

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