Acute gastric volvulus in a pediatric patient: A rare case report

Acute gastric volvulus is an extremely rare but possibly lethal condition within the pediatric population and is defined by the abnormal rotation of the stomach that can lead to serious complications like ischemia, perforation, or splenic involvement if not promptly diagnosed and managed. We report the case of a 2-year-old male with a history of Chromosome Alignment-Maintaining Phosphoprotein 1 (CHAMP1) mutation and prior gastric ulcers who presented with hematemesis, retching, and feeding intolerance. Abdominal radiograph showed nonspecific dilation of the gastric bubble, and contrast-enhanced computed tomography (CT) confirmed mesentero-axial volvulus with splenic displacement. The patient underwent successful nasogastric decompression followed by laparotomy, gastric detorsion, and percutaneous endoscopic gastrostomy tube placement. This case emphasizes the role of early imaging, particularly CT, in diagnosing pediatric gastric volvulus and suggests a potential link between CHAMP1-associated hypotonia and volvulus. Timely recognition and intervention are essential for favorable outcomes in such rare pediatric emergencies.