A Case of Acute Organo-axial Gastric Volvulus with Elongated Transverse Colon

Abstract

A 70-year-old man, who had a feeling of fullness and nausea from that morning, visited our hospital due to vomiting at midnight. Plain abdominal CT demonstrated a severely dilatated stomach in the right side abdomen, duodenal bulbus in the left upper abdomen, and a normal position spleen. He was thus admitted under a diagnosis of acute gastric volvulus. Anasogastric tube was inserted, after which his symptoms disappered. An upper gastrointestinal radiographic examination was performed. At the start of the examination, his stomach was in the normal position, but during the examination, organo-axial torsion was seen again. On the following morning, the shape of the stomach was in the normal position on x-ray imaging, so he started taking food again. Three days later, he vomited again and gastric volvulus recurred. After nasogastric tube drainage, an upper gastroscopy was performed, but there were no abnormal findings. On lower digestive tract radiographic examination, the left side of the transverse colon was elongated, and located to the upper-anterior side of the stomach. Laxity of the gastrosplenic ligament and gastrocolic ligament was suspected. We made a diagnosis of acute organo-axial gastric volvulus with transverse colon elongation. We report herein on a case of acute organo-axial gastric volvulus with transverse colon elongation, succesfully treated with gastropexy and partial resection of the left side transverse colon.