2022 Volume 64 Issue 9 Pages 1557-1563
An 81-year-old man was admitted to our hospital for evaluation of upper abdominal pain and vomiting. Plain CT on admission revealed dilatation of the stomach. Gastric tube insertion followed by decompression led to improvement in symptoms, and EGD revealed no organic lesion to account for gastrointestinal obstruction. The patient experienced the same symptoms after meals, and we diagnosed gastric volvulus based on plain CT findings. Standard surgical treatment was associated with a high risk in this patient with respiratory dysfunction secondary to chronic obstructive pulmonary disease; therefore, we performed endoscopic four-point gastropexy as a minimally invasive alternative. Few studies have reported endoscopic gastropexy for gastric volvulus, and a definitive fixation method remains unclear. Endoscopic four-point gastropexy may be a useful therapeutic strategy to prevent recurrent gastric volvulus.
