Severe acute gastric volvulus: A case report with perforation and extra-gastric ischemic findings.
Samet Paydas, Mehmet Aykut Yildirim
✦ AI-curated · Sources linked
Case in brief
A 36-year-old man presented with sudden abdominal distension and respiratory distress, with severe hemodynamic instability and an acute abdomen. Imaging showed intraperitoneal free air, leading to emergency laparotomy. Surgeons found a 270° gastric volvulus with gastric ischemia and perforation, as well as small-bowel pneumatosis intestinalis and a perforated Meckel’s diverticulum, considered likely secondary to increased intra-abdominal pressure. Despite early surgery, he developed refractory shock and died in the early postoperative period.
What made this case unusual
The gastric volvulus was accompanied by both small-bowel pneumatosis intestinalis and Meckel’s diverticulum perforation, findings the authors considered likely related to increased intra-abdominal pressure.
Diagnostic / clinical pearl
Sudden abdominal distension with respiratory distress and rapid deterioration should prompt consideration of acute gastric volvulus, even when the presentation is nonspecific.
Why it matters
The case illustrates that severe hemodynamic instability and multiple intra-abdominal complications may be associated with a fatal outcome despite early surgical intervention.