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VOLUME 56 , ISSUE 3 ( July-September, 2022 ) > List of Articles


Intrathoracic Chronic Gastric Volvulus Secondary to Paraesophageal Hernia in a Young Adult: A Case Report

Rajesh Sharma, Ashish Chauhan, Brij Sharma, Vishal Bodh, Neeti Aggarwal, Ashok Kaundal

Keywords : Bochardt's triad, Gastric volvulus, Hiatal hernia, Organoaxial volvulus, Paraesophageal hernia

Citation Information : Sharma R, Chauhan A, Sharma B, Bodh V, Aggarwal N, Kaundal A. Intrathoracic Chronic Gastric Volvulus Secondary to Paraesophageal Hernia in a Young Adult: A Case Report. J Postgrad Med Edu Res 2022; 56 (3):131-133.

DOI: 10.5005/jp-journals-10028-1577

License: CC BY-NC 4.0

Published Online: 01-10-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Gastric volvulus is a rare disorder seen commonly in elderly individuals with 50% of cases reported in association with hiatal hernia. Gastric volvulus commonly presents acutely as a surgical emergency, but chronic variant is also well documented. Case description: We report a case of 35-year-old gentleman, who presented with epigastric pain, postprandial fullness and weight loss of 13 kg in last 6 months. In gastroduodenoscopy, crossing gastroesophageal junction (GEJ) required maneuvering due to abnormal anatomy of stomach and on retroflexion, possible paraesophageal hernia was seen with torsion around scope. CECT abdomen was suggestive of type 3 paraesophageal hernia with gastric volvulus. Patient underwent open laparotomy with repair of hernia and devolvulization of stomach. Discussion: Gastric volvulus is characterized by abnormal rotation of the stomach around one of its axes leading to foregut obstruction with a risk of strangulation. Treatment involves devolvulization of stomach with correction of underlying pathology. Endoscopic treatment has evolved in recent years with endoscopic devolvulization and percutaneous endoscopic gastrostomy being tried as less invasive approaches, but, most of the patients require surgery either laparoscopic or open. Conclusion: High index of suspicion is needed to diagnose gastric volvulus, especially chronic variant. Any delay can lead to gastric ischemia and necrosis, and can be fatal.

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