Mesenteroaxial gastric volvulus validly diagnosed by computed tomography

Abstract

A 78-year-old man was referred to the hospital because of abdominal pain and vomiting. Plain chest x-ray showed an elevated left hemidiaphragm with a large gastric air bubble beneath it. The CT scan showed a dilated fluid-filled stomach, and the gastric antrum was moving behind the body and the pyloric region was located in the superior and anterior side of the cardia. A diagnosis of mesenteroaxial gastric volvulus was made, then endoscopic reduction was attempted. As an ordinary gastroscope could not pass through the antrum, an endosope for lower digestive tract was utilized. The longer scope could reach the second portion of the duodenum, and successful reduction of the volvulus was performed.
The CT scan is valid to diagnose gastric volvulus because of capability of building three-dimensional images. Endoscopic reduction utilizing a longer endoscope is a good choice for the adult-onset volvulus.