Remedy Publications LLC., | http://surgeryresearchjournal.com World Journal of Surgery and Surgical Research 2020 | Volume 3 | Article 1236 1 Gastric Volvulus: A Challenge to Diagnosis and Management OPEN ACCESS *Correspondence: Faisal El Mouhafd, Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Ryad, Rabat, Morocco, E-mail: faisalmohafd@gmail.com Received Date: 01 Jun 2020 Accepted Date: 03 Jul 2020 Published Date: 07 Jul 2020 Citation: El Mouhafd F, Yaka M, Bounaim A, Moujahid M. Gastric Volvulus: A Challenge to Diagnosis and Management. World J Surg Surgical Res. 2020; 3: 1236. Copyright © 2020 Faisal El Mouhafd. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Case Report Published: 07 Jul, 2020 Abstract Introduction: Gastric Volvulus (GV) is a rare disease. Te exact incidence of GV is unknown and patients with a chronic presentation may never be diagnosed. Te peak age group of incidence is in the ffh decade. Te volvulus can be classifed as organoaxial and mesenteroaxial. Te clinical presentation of gastric volvulus depends on the degree of rotation and the rapidity of onset. Case Presentation: An 86-year-old man came to the emergency department presenting with abdominal pain of 48-h progression with dyspnea, nausea with no vomiting. Nasogastric tube placement was unsuccessful. An abdominal computed tomography scan was revealed a volvulus gastric with pneumoperitoneum. Emergency surgery was indicated and a typical gastrectomy was performed. Conclusion: Acute GV usually presents with Borchardt’s triad. With the advent of CT and laparoscopic surgery, the gold standards for diagnosing and treating this disease are ever evolving. Surgical treatment should be performed according to aetiology and to patient’s characteristics. Keywords: Gastric volvulus; Management of gastric volvulus; CT Faisal El Mouhafd*, Mbarek Yaka, Ahmed Bounaim and Mountassir Moujahid Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Morocco Abbreviation GV: Gastric Volvulus; CT: Computed Tomography Introduction Acute gastric volvulus is rare clinical condition and is considered a medical emergency and defned as the pathological rotation of the stomach by more than 180° [1-2]. It was frst described in 1866 by Berti based on the autopsy of a 61-year old woman [3]. Te peak age group of incidence is in the ffh decade with children less than one year old making up 10% to 20% of cases. No association with either sex or race has been reported [4,5]. In 30% of cases the volvulus occurs as a primary event, but it is more commonly secondary to another cause [4,6]. Clinical presentation may vary from occasional non-specifc symptoms to life-threatening situations [7]. Te main consequence of the disorder is foregut obstruction that may be acute, recurrent, intermittent or chronic [5,8,9]. Furthermore, there is a risk of strangulation which may result in necrosis, perforation and hypovolemic shock. As such, the mortality rates for acute volvulus range from 30% to 50% highlighting the importance of early diagnosis and treatment [4,6,9,10]. Case Presentation An 86-year-old man came to the emergency department presenting with abdominal pain of 48-h progression that initially was epigastric and then became generalized. Her other symptoms were epigastric pain with dyspnea, nausea with no vomiting, and a progressively deteriorating general health status; as the hours progressed, the level of consciousness began to diminish. Upon arrival he presented with hypotension (blood pressure 75/40 mmHg), tachycardia (130 bpm), tachypnea (28 rpm), and desaturation (SaO 2 : 85%). Te frst examination revealed a distended and tympanic abdomen with difuse pain upon palpation and obvious signs of generalized peritoneal irritation. Nasogastric tube placement was unsuccessful. Blood analysis showed elevated levels of C-reactive protein and procalcitonin – 110 mg/l and 282 ng/ml, respectively -, leukopenia (1,200 l/ml), acute renal failure (urea of 69 mg/dl and creatinine of 1.68 mg/dl), and hypoxemia with compensated metabolic acidosis. Electrocardiogram results showed no signs of acute myocardial ischemia. Crystalloid and colloid resuscitation was begun due to the symptoms of shock, and once the hemodynamic parameters improved, an abdominal computed tomography scan was carried