Mesentero-axial gastric volvulus

Case contributed by Dr Maxime St-Amant

Presentation

Retching without vomiting. Acute abdominal pain. Recent surgery for hiatal herniation.

Patient Data

Age: 65
Gender: Female

In this patient with a para-esophageal hernia, the esophago-gastric junction is located inferiorly to the gastric antrum, and there is a moderate gastric distension. A little quantity of free fluid is seen near the gastric fundus and surrounding the intra-thoracic stomach. The findings are highly suggestive of mesentero-axial gastric volvulus. A surgical consultation is recommended. 

Annotated image

Case Discussion

This patient also presented the Borchardt triad consisting of :

1) inability to pass a nasogastric tube

2) severe epigastric pain

3) retching without vomiting

The diagnosis was confirmed per-operatively.

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Case information

rID: 19257
Case created: 21st Aug 2012
Last edited: 12th Mar 2017
Inclusion in quiz mode: Included

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