Gastric volvulus in an adult: A case report.
- Author:
Nikki RILLON-TABIL
;
Paolo VILLAREAL
;
Albert ISMAEL
- Publication Type:Case report
- MeSH:
X
- From:
Philippine Journal of Internal Medicine
2012;50(1):23-25
- CountryPhilippines
-
Abstract:
Background: Gastric volvulus is an emergency which warrants immediate correction. It presents clinically with epigastric pain radiating to the back and or left thoracic area or left upper abdominal quadrant, retching and difficulty in passing a nasogastric tube.Case Report: This is a case of a 55-year old male, who had a six-year history of mild, intermittent epigastric pain, bloatedness and occasional retching.Two weeks prior to admission, he had severe, nonradiating epigastric pain accompanied by coffee-ground vomitus, and melena. Chest radiograph revealed an air fluid level in the left lower lungfield. Upper gastrointestinal endoscopy revealed twisting of the rugal folds at a constriction seen at the midportion of the gastric body. Upper gastrointestinal series showed that the stomach was located intraabdominally, but the fundus was seemingly connected to the duodenum, while the distal esophagus was connected to the distal part of the stomach. Exploratory laparotomy was done which revealed a Morgagni hernia with the stomach located in the thorax and rotated along its transverse axis. Reduction and repair of hernia were done.Conclusion: Gastric volvulus mimics many conditions including gastric distention, cardiopulmonary diseases, cholecystitis, gastric and duodenal ulcer andpancreatitis. Therefore, it can be included in the differential diagnosis of chronic abdominal pain.
