Chronic Mesentero-Axial Gastric Volvulus Associated with a Parahiatal Diaphragmatic Hernia: A Rare Entity

Gastric volvulus, a rare entity, seldom presents with diaphragmatic hernia and is usually missed during preliminary workup (Demmy et al. in Ann Thorac Surg [Internet] 58(1):226-227, 2010). We present the case of a 55-year-old lady who presented with vomiting, pain upper abdomen, heartburns, and episodic unproductive retching for the past 6 months. The diagnosis of diaphragmatic hernia was made on erect chest X-ray and the barium study findings. Intraoperatively, a mesentero-axial gastric volvulus was found to be associated with a parahiatal hernia (Scheidler et al. in Ann Thorac Surg 73(2):416-419, 2002). The contents were reduced back into the abdomen, and diaphragmatic defect was approximated. Chronic gastric volvulus with or without diaphragmatic hernia should be kept as a differential in old age groups suffering from intractable dyspepsia unresponsive to conventional therapies (McElreath et al. in Dig Dis Sci 53(11):3033-3036, 2008; Teague et al. in Br J Surg 87(3):358-361, 2000).