Successful management of an elderly woman with organoaxial gastric volvulus: a case report

Introduction: Organoaxial gastric volvulus is a rare condition whose clinical presentations and optimal management remain poorly understood. In this case report, we describe an elderly woman with acute organoaxial gastric volvulus who was successfully managed at our center. Case presentation: The patient was a 70-year-old woman who presented to our tertiary hospital with abdominal pain, nausea, vomiting, and intolerance to oral intake for 3 days prior to admission. She had a history of several emergency department admissions in the year prior to admission due to gastrointestinal symptoms and nausea. Plain abdominal radiography was suggestive of gastric volvulus, and the diagnosis was confirmed by a spiral abdominopelvic computed tomography (CT) scan. The patient underwent surgical treatment for gastric outlet obstruction secondary to organoaxial gastric volvulus, which resolved her symptoms. Discussion: Certain conditions, such as hiatal hernia and trauma, predispose patients to organoaxial gastric volvulus. Surgical management remains the cornerstone of treatment, particularly in the acute phase; addressing the underlying cause, such as a hiatal hernia, should also be considered to avoid recurrence. Conclusion: Organoaxial gastric volvulus can present with both chronic and acute symptoms, and delays in diagnosis, particularly during phases of less severe gastrointestinal symptoms, may lead to progressive worsening over time, potentially resulting in gastric outlet obstruction.