Presentation
Retching without vomiting. Acute abdominal pain. Recent surgery for hiatal herniation.
Patient Data
Age: 65 years
Gender: Female
From the case:
Mesentero-axial gastric volvulus
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In this patient with a para-esophageal hernia, the esophago-gastric junction is located inferiorly to the gastric antrum, and there is 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. Surgical consultation is recommended.
From the case:
Mesentero-axial gastric volvulus
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These diagrams show the difference in the mechanism of formation in both types of gastric volvulus.
Author: Maxime St-Amant
License: CC-NC-BY-SA
Case Discussion
This patient also presented the Borchardt triad consisting of :
- inability to pass a nasogastric tube
- severe epigastric pain
- retching without vomiting
The diagnosis was confirmed per-operatively.
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