Gastric Volvulus

Aka: Gastric Volvulus, Stomach Volvulus, Organoaxial Gastric Volvulus, Mesenteroaxial Gastric Volvulus, Borchardt Triad

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II. Epidemiology

  1. Rare condition occuring at the extremes of age

III. Pathophysiology

  1. Elderly represent most cases
    1. Volvulus occurrs within large paraesophageal Hernias
    2. Stomach typically twists along its long axis (organoaxial Volvulus)
  2. Infants (20% of cases)
    1. Volvulus occurrs within congenital Diaphragmatic Hernias
    2. Stomach typically twists along its short axis (Mesenteroaxial Volvulus)

IV. Findings

  1. Borchardt Triad
    1. Severe Epigastric Pain
    2. Abdominal Distention
    3. Vomiting

V. Management

  1. Attempt Nasogastric Tube placement
    1. Often difficult to pass, but if successful, may reduce Volvulus
  2. Consult surgery emergently
    1. However, unlike other Volvulus, redundant circulation often prevent gastric infarction

VI. Resources

  1. Radiopaedia
    1. https://radiopaedia.org/articles/gastric-volvulus?lang=us

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