Hiatal hernia complicated by gastric volvulus: case report

Gastric volvulus is a rare and potentially life-threatening complication of large hiatal hernias. It is defined as the abnormal rotation of the stomach by >180° around one of its axes, leading to closed-loop obstruction and risks of ischemia and perforation. We present a case of an 84-year-old female presented with severe epigastric pain associated with coffee ground vomiting. Esophagogastroduodenoscopy and computed tomography scan confirmed a large hiatal hernia complicated by gastric volvulus. Surgical intervention was done with a tension-free gastropexy following a partial reduction of the hiatal hernia. Postoperative recovery was closely monitored in the intensive care unit, and the patient gradually improved and was discharged home after 17 days. This report highlights the importance of considering gastric volvulus in the differential diagnosis of upper abdominal pain and vomiting, particularly when associated with hiatal hernia in elderly patients.