Presentation
Anemia with large hiatus hernia. To delineate anatomy.
Patient Data
Age: 75
Gender: Female
From the case:
Incomplete mesentero-axial volvulus of the stomach
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Preliminary AP
- Preliminary images demonstrate a hiatus hernia with the appearance of two gastric air bubbles, one above and one below the diaphragm
- The upper and mid esophagus are unremarkable
- Minor hold up of contrast and tertiary peristalsis in the distal esophagus
- Mesentero-axial rotation of the stomach with the antrum and pylorus located superiorly within the chest through a large diagphragmatic hiatus, and the cardia and fundus located inferiorly
- The gastro-esophageal junction appears normal in diameter
- The stomach is not significantly dilated
- Contrast solution passes through to the duodenum
Findings are consistent with hiatus hernia and incomplete gastric mesoentero-axial rotation or volvulus (<180°).
Case Discussion
Mesentero-axial rotation or volvulus is less common in the adult population than organo-axial, and is most commonly incomplete (<180°). The complete form of meso-axial volvulus (>180°) is associated with severe obstruction and strangulation.
Barium study findings in this case were consistent with those at endoscopy.
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