Abstract
A 90-year-old female patient with vomiting and loss of appetite underwent an endoscopic examination of the upper gastrointestinal tract, which revealed multiple ulcers at the greater curvature of the stomach and a large quantity of gastric contents. Abdominal computed tomography (CT) showed an organoaxial gastric volvulus, but there were no ischemic changes. Inflammatory reactions appeared on the third disease day, and the CT scan showed abdominal free air. An emergency operation was performed. The greater curvature had rotated, and had adhered to the right lobe of the patient's liver. There was a perforation in the stomach. We affixed the stomach to the abdominal wall after performing a partial gastrectomy. Histological examination of the resected specimen showed ulcerative lesions composed of necrotic inflammatory granulation tissue and regenerative gastric mucosa. Several blood vessels contained thrombi with various phases of organization. It was thus concluded that the perforation of the stomach had been caused during a period of chronic ischemia.
