Gastric volvulus

Gastric volvulus or volvulus of stomach is a twisting of all or part of the stomach by more than 180 degrees with obstruction of the flow of material through the stomach, variable loss of blood supply and possible tissue death. The twisting can occur around the long axis of the stomach, called organoaxial, or around the axis perpendicular to this, called mesenteroaxial. Obstruction is more likely with organoaxial twisting than with mesenteroaxial, while the latter is more associated with ischemia. About one third of the cases are associated with a hiatal hernia. Treatment is surgical.

The classic triad (Borchardt's Triad) of gastric volvulus, described by Borchardt in 1904, consists of severe epigastric pain, retching (due to sour taste in mouth) without vomiting, and inability to pass a nasogastric tube. It reportedly occurs in 70% of cases. Sometimes, severe pain at the top of left shoulder occurs. This may be due to internal bleeding irritating the diaphragm upon respiration.