Abstract
Acute gastric volvulus which usually necessitates surgical procedures was successfully treated by endoscopic reduction. The patient was a 28-year-old man who had complained of nausea and abdominal pain for about 20 hours before admission. His upper abdomen was swollen. Chest X-ray examination demonstrates raised left diaphragm, and abdominal X-ray examination revealed a huge quantity of air and fluid filling a massively enlarged stomach beneath the diaphragm. Fluoroscopic examination of the stomach showed a gastric volvulus of mesenteric type and occlusion in the pyloric antrum. A forward-viewing endoscope was inserted in a reverse "alpha" direction. And the endoscope could be further inserted into the duodenum, when the patient was placed to a prone position. After the endoscope was pulled up with its tip hooking at the duodenum, rotation was corrected. Acute gastric volvulus can be treated for safety by endoscopic reduction, when passage of the cardiac part of the stomach is maintained and stranguration due to rotation is slight.
