Acute gastric volvulus: pathogenesis, diagnosis, and treatment.

A 61-yr-old women presented with vomiting, abdominal pain, and distention. Nasogastric and endoscopic decompression failed to relieve her distention. Radiographic studies suggested gastric necrosis without other pathology. Laparotomy revealed a rare form of mesenteroaxial volvulus of the fundus with frank necrosis. The patient underwent gastric resection with anterior gastropexy followed by an uncomplicated postoperative course. This paper discusses the etiology, anatomic definition, and therapeutic options in patients with acute gastric volvulus.