To characterize the main findings of gastric volvulus. To illustrate the importance of computed tomography (CT) imaging for diagnosis and classification. To describe the main complications of this pathology and its treatment.

BASIC CONCEPTS DEFINITION Rotation and abnormal position of the stomach on one or several axes. Favored by predisposing conditions Primary: suspensory ligaments of the stomach altered (gastro-hepatic, gastro-phrenic, gastro-colic and gastro-splenic). Secondary: anatomical abnormalities not associated with the suspensory ligaments (diaphragmatic hernia). It is the most frequent type. DEMOGRAPHY Adults > 50 years, without sex predilection. Up to 30% in the pediatric population. RISK FACTOR'S Diaphragmatic hernias; weakness of the phrenic nerve; stomach and spleen congenital anomalies (ligament involvement); bariatric surgery, kyphoscoliosis. TERMINOLOGY Saying "volvulus"...

ILLUSTRATIVE CLINICAL CASE FOR DISCUSSION INTERVIEW 79-year-old woman. Eight years of abdominal pain in the epigastrium and right hemithorax exacerbated 3 days ago. It is associated with dyspnea and dry cough. Denies dysphagia, emesis or bleeding. BACKGROUND Arterial hypertension; cholecystectomy, cystopexy, oophorectomy, hysterectomy. PHYSICAL EXAM Tachycardia and tachypnea without fever. Reduction of respiratory noises in the low aspect of the right hemithorax. Mild to moderate abdominal pain in the epigastrium and right hypochondrium without signs of peritoneal irritation. INITIAL MANAGEMENT Given age and chronicity, contrasted...

Rotational pathologies of the stomach are rare, even more, the presence of a life-threatening volvulus. It is necessary to think about this diagnosis in a patient with nonspecific epigastric symptoms. Late diagnosis may generate important complications such as ischemia, gastric necrosis, and death, in some cases. Only diagnostic imaging, particularly computed tomography will identify and classify gastric volvulus, which is essential to guide optimal management.

Dr. Jefferson Castellanos Resident in training. Department of Radiology, Hospital Universitario del Valle. 36-08 5th Avenue. 760043. Universidad del valle. Cali, Colombia. Nothing to disclose

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