A case of endoscopic amelioration of ischemia caused by volvulus of the stomach

An 83-year-old woman was taken to our hospital due to postprandial abdominal pain and nausea. Computed tomographic (CT) scan showed gastric dilatation and volvulus of the stomach, and insertion of a gastric tube revealed copious drainage. On day 3, blood tests showed markedly elevated inflammatory response and creatine kinase, and a contrast CT scan suggested ischemia due to volvulus of the stomach. Fluoroscopic endoscopy was performed, and a lower gastrointestinal scope could be passed through the pyloric ring and successfully released the volvulus. On day 10, fluoroscopic endoscopy was performed again, and the ischemic changes improved, but the volvulus had recurred. Endoscopic repair was judged to be inadequate, and laparotomy with gastric fusion and diaphragmatic hernia repair was performed on day 14. Volvulus of the stomach may cause blood flow disturbance, and early endoscopic repair may be useful for avoiding gastrectomy.