Comprises rotation of part/all of the stomach, leading to obstruction with or without ischaemia. The typical presentation is with the Borcha...
Comprises rotation of part/all of the stomach, leading to obstruction with or without ischaemia. The typical presentation is with the Borchadt triad: severe pain, retching and inability to pass an NG tube. There are two types:
1. Organoaxial—most common
– Rotation occurs around the long axis of the stomach so that the greater curvature ends lying cranially—‘upside down’ stomach.– Usually chronic and asymptomatic, complications are rare.– More common with large hiatus hernias.
2. Mesenteroaxial—rare
– Rotation occurs around the gastrohepatic ligament so the distal stomach may be projected over or above the fundus.– Obstruction and ischaemia is common.– Associated with traumatic diaphragmatic rupture.
PLAIN FILM
• Unexpected location of the gastric bubble• Air-fluid levels in the mediastinum• Distended, gas-filled stomach
CT
• Abnormal location of gastric structures
Organoaxial gastric volvulus. Barium meal demonstrating the stomach to have revolved around its long axis with the great curvature lying cranial.
Mesenteroaxial gastric volvulus. Barium meal demonstrating the stomach to have revolved with the distal stomach projected above the fundus.
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