A Case of Patient with Gastric Volvulus Coexisting with Sigmoid Volvulus Recovered by Emergency Surgery

Abstract

A 65-year-old man presented to the emergency department with primary complaints of abdominal distension and nausea that had started on the previous day. Plain abdominal computed tomography (CT) showed a gastric volvulus that was released by intubation. Esophagogastroduodenoscopy (EGD) was performed the following day, and multiple gastric ulcers were noted primarily in the gastric corpus. No gastric axial change was observed. On day 7 post-admission, the patient developed sudden abdominal pain and nausea reflex, which were associated with muscular defense. Contrast-enhanced abdominal CT revealed acute gastric dilatation and whirlpool signs in the epigastric blood vessels. Additionally, EGD showed exacerbated gastric ulcers and axial changes in the stomach. Therefore, he was diagnosed with acute gastric volvulus and the patient underwent emergency surgery. Intraoperative findings confirmed sigmoid volvulus, gastric volvulus, gastric volvulus release, and sigmoid fixation. In gastric volvulus, the possibility of gastric volvulus coexisting with sigmoid volvulus should be considered, particularly when conservative treatment is ineffective. Minimally invasive emergency surgery should also be performed.