A Case of Idiopathic Gastric Volvulus Resulting in Gastric Perforation

Abstract

A 72-year-old man with previous gastric volvulus treated by conservative therapy visited the previous hospital because of upper abdominal pain and vomiting. Abdominal X-ray examination and plain computed tomography (CT) showed gastric dilatation and volvulus. He was diagnosed as having gastric volvulus and received conservative therapy, but his symptoms did not improve. An additional contrast-enhanced CT showed free air in the upper abdomen, although the volvulus was resolved. With the diagnosis of gastric perforation secondary to gastric volvulus, he was transferred to our hospital for emergency surgery. At the time of arrival at our hospital, the abdomen was firm and board-like, and tenderness was observed in the epigastrium. During the operation, a 10-mm-diameter perforation was found in the posterior wall of the stomach. Gastric fixation was poor. The perforation was sutured closed, and the gastric fornix was suture-fixed to the left diaphragm to prevent recurrence of gastric volvulus. He was discharged on the 10^th postoperative day without any complications. Since gastric perforation secondary to adult idiopathic gastric volvulus is rare, this case is reported along with a review of the relevant literature.