Endoscopic Reduction of an Acute Gastric Volvulus

TL;DR

A 52-year-old man with a paraesophageal hernia developed acute gastric volvulus, successfully managed with endoscopic detorsion and laparoscopic gastropexy.

Contribution

This case report highlights the successful endoscopic management of acute gastric volvulus in the context of a paraesophageal hernia.

Findings

CT imaging confirmed a paraesophageal hernia with mesenteroaxial gastric volvulus.

Endoscopic detorsion provided temporary relief before laparoscopic gastropexy.

The patient recovered well and is scheduled for Roux-en-Y gastric bypass surgery.

Abstract

We are reporting a case of gastric volvulus in a 52-year-old man in the setting of a paraesophageal hernia initially identified on computerized tomography (CT). CT of the abdomen showed a large paraesophageal hernia with intra-thoracic herniation of the distal stomach and gastroduodenal junction, resulting in mesenteroaxial rotation consistent with acute gastric volvulus. Esophagogastroduodenoscopy (EGD) confirmed the presence of the gastric volvulus, which was initially temporized with endoscopic detorsion. He subsequently had nasogastric tube placement and ultimately underwent a laparoscopic gastropexy. He recovered uneventfully with plans for Roux-en-Y gastric bypass surgery.

Figures