Gastric Volvulus

A recent case has reminded me of the rare but important problem of Gastric Volvulus. Patients may have chronic symptoms of upper abdominal pain and vomiting, but not typical of peptic ulcer. A Gastroscopy may show altered anatomy but may be interpreted as normal. The best test to determine if there is an actual volvulus is a Barium Meal, performed by an experienced GI Radiologist. It is also very important to remember that patients found to have a tendency to a Gastric Volvulus usually merit surgery to prevent an acute volvulus (with gastric infarction), which in turn would lead to the need for emergency Gastrectomy and a significant mortality. It is generally much better to have an elective operation to fix the stomach in position and prevent an acute volvulus.

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