A case of acute gastric volvulus due to diaphragmatic hernia in an adult with kyphoscoliosis

Abstract

Gastric volvulus is rotation of stomach or its part by more than 180 degree creating closed loop obstruction. Gastric volvulus is rotation of stomach around any of the stomach axis which includes organ-axial and mesoaxial. There are two types of gastric volvulus; primary and secondary. Primary gastric volvulus is loosening of ligamentary support of stomach. The secondary gastric volvulus is because of diaphragmatic hernia and paraesophageal hernia. Diaphragmatic hernia is a condition with defect in the diaphragm causing protrusion of intraabdominal organs into thoracic cavity. Most common cause being congenital. Borchardt’s triad may not be present as many as 25% of patients which include difficulty inserting a nasogastric tube, nonproductive vomiting, severe and constant epigastric pain. Large number of patient presented in middle age, up to 75% associated with an abdominal adhesions, paraesophageal hiatal hernia, or other intraabdominal or diaphragmatic conditions. Acute gastric volvulus is an emergency and strong suspicion, early resuscitations, imaging, diagnosis and urgent surgical treatment is prompt to save life of patient from complications such as perforation, gangrene, shock which increased chance of morbidity and mortality.