Radiological features of acute gastric volvulus in adult patients Hassan Al-Balas a, ⁎ , Mohammed Bani Hani b , Hamzi Z. Omari a a Department of Radiology, King Abdullah University Hospital, P. O. Box 6300001, Irbid, 21110, Jordan b Department of Surgery, King Abdullah University Hospital, P. O. Box 6300001, Irbid, 21110, Jordan Received 8 August 2009; accepted 9 September 2009 Abstract Objective: To evaluate the radiological features of acute gastric volvulus in adults and correlate these features with operative findings. Materials and Methods: The clinical, radiological and operative findings of five adult patients (four males and one female with mean age of 50.4 years) who presented or referred to King Abdullah University hospital over 4 year’s period with symptoms of acute gastric volvulus were reviewed retrospectively. All patients underwent upper gastrointestinal barium study and two of them had computed tomographic (CT) scans preoperatively. The radiological features demonstrated on upper gastrointestinal barium exams and CT scans were analyzed and compared with operative findings. Results: Radiological and operative findings revealed organo-axial gastric volvulus in all patients in our study. All of them had associated diaphragmatic defect or hiatal hernia. The upper gastrointestinal barium studies demonstrated the classic radiological features of organo-axial volvulus. CT done on two of our patients confirmed the diagnosis. Conclusion: Upper gastrointestinal barium study is an accurate way to diagnose and characterize acute gastric volvulus in adult patients. CT scan can also be used to diagnose this clinical entity. © 2010 Elsevier Inc. All rights reserved. Keywords: Acute gastric volvulus; Upper gastrointestinal Barium study; CT 1. Introduction Acute gastric volvulus is a rare acute surgical emergency that involves abnormal rotation of the stomach along one of its axis by more than 180° resulting in closed loop obstruction. Delay in the diagnosis can lead to catastrophic consequences including gastric necrosis and strangulation [1]; therefore, early recognition of the fairly characteristic radiological features of this entity can be lifesaving [2]. Beri was the first to fully describe this acute surgical entity in 1866 on autopsy. Rosselet in 1920 fully described its radiological features. Thereafter, this entity had been described more frequently and recognized as an important etiology of acute abdomen. Gastric volvulus has been classically classified into either organo- or mesentero-axial types. When the stomach rotates around an axis line connecting the gastro-esophageal junction and pylorus, the term organ-axial volvulus is used. Mesentero-axial gastric volvulus is used when the stomach rotates around an imaginary transverse line connecting the middle of lesser and greater curvatures of the stomach. We described the radiological features of acute gastric volvulus seen on upper gastrointestinal Barium studies and computed tomographic (CT) scans. This description is aimed at better understanding of these features so that early radiological diagnosis can be achieved. 2. Materials and methods The clinical presentations and radiological features of all adult patients who underwent surgical repair for acute gastric volvulus between 2002 and 2006 at our hospital were retrospectively reviewed. Over 4 year's period, a total of 5 cases of acute gastric volvulus either presented or were referred to our hospital. Patients with chronic presentations were excluded from this study. Clinical Imaging 34 (2010) 344 – 347 ⁎ Corresponding author. Department of Radiology, King Abdullah University Hospital, Irbid, Jordan. E-mail address: albalas@yahoo.com (H. Al-Balas). 0899-7071/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.clinimag.2010.02.001