Gastric Volvulus

Gastric volvulus or volvulus of stomach a twisting of all or part of the stomach by more than 180 degrees with obstruction of the flow of material through the stomach, variable loss of blood supply and possible tissue death. The twisting can occur around the long axis of the stomach: this is called organoaxial or around the axis perpendicular to this, called mesenteroaxial. Obstruction is more likely in organoaxial twisting than with mesenteroaxial while the latter is more associated with ischemia. About one third of the cases are associated with a hiatus hernia. Treatment is surgical.

The classic triad of gastric volvulus, described by Borchardt in 1904, consists of severe epigastric pain, retching without vomiting, inability to pass a nasogastric tube and sometimes severe pain at the top of left shoulder, this may be due to internal bleeding irritating the diaphragm upon respiration.