Organo-axial gastric volvulus

Case contributed by Mohammad A. ElBeialy
Diagnosis certain


Severe epigastric pain and vomiting.

Patient Data

Age: 40 years
Gender: Male

A large para-cardiac opacity with air fluid level is seen silhouetting the right diaphragmatic copula and not the right cardiac border with splaying of the carina suggesting it is a posterior mediastinal lesion.

A large hiatus hernia with evidence of oragano-axial gastric volvulus ; the stomach is turned upside down (with the antrum located antero-superiorly and the fundus postero-inferiorly) and totally herniating into the posterior mediastinum abutting and compressing the left atrium and abutting the descending aorta. 

The stomach is dilated with air fluid level as well as mild dilatation of the proximal esophagus

Case Discussion

A large hiatus hernia with organoaxial gastric volvulus. 

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