Mesentero-axial gastric volvulus

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Epigastric pain related to meals and retching.

Patient Data

Age: 65
Gender: Male
CT

CT abdomen with contrast

The gastro-esophageal junction is below the pyloro-duodenal junction; the gastric antrum is above gastro-oesophageal junction; the antrum and pylorus are superior to the fundus and proximal body and so the stomach appears of twisted configuration.

The spleen is in abnormal position, being more inferomedial in location intimately related to gastroesophageal junction (wandering spleen).

The heart is enlarged, the liver shows cirrhotic changes and mild free ascites at the perihepatic region.

Multiple bilateral small renal cysts.

Case Discussion

The stomach is twisted over its axial plane (short axis) along the mesenteric attachment with a replaced position of the gastroesophageal and the pyloroduodenal junction, with the latter being in superior level. There is no associated diaphragmatic hernia. Wandering spleen is noted which is an association. No evidence of gastric ischemic changes. Gastric volvulus can occur at any age, however it is more common in children especially the mesentero-axial type.

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Case information

rID: 56445
Case created: 1st Nov 2017
Last edited: 17th Nov 2017
Inclusion in quiz mode: Included
Institution: DAR ELASHAA center

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