Aljubori Salman Abdullah, Abu Sulami Rouz Faisal, Aljohani Abdullah Khalid, Zahid Maram Mohammed, Osama Sally
Department of General Surgery, King Salman Bin Abdulaziz Medical City, Medina, Saudi Arabia.
Department of Medicine and Surgery, College of Medicine, Taibah University, Medina, Saudi Arabia.
J Surg Case Rep. 2025 Sep 2;2025(9):rjaf648. doi: 10.1093/jscr/rjaf648. eCollection 2025 Sep.
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.
胃扭转是大型食管裂孔疝罕见且可能危及生命的并发症。它被定义为胃围绕其某一轴线旋转>180°，导致闭环梗阻以及缺血和穿孔风险。我们报告一例84岁女性患者，表现为严重上腹痛并伴有咖啡渣样呕吐。食管胃十二指肠镜检查和计算机断层扫描证实为大型食管裂孔疝合并胃扭转。在部分回纳食管裂孔疝后，行无张力胃固定术进行手术干预。在重症监护病房密切监测术后恢复情况，患者逐渐好转，17天后出院。本报告强调了在鉴别诊断上腹痛和呕吐时考虑胃扭转的重要性，尤其是在老年患者合并食管裂孔疝时。
