A rare cause of severe epigastric pain, emesis and increased lipase

Abstract

Introduction: Gastric volvulus is an uncommon, but severe pathology requiring early diagnosis and urgent treatment. Its atypical symptoms and rarity make it difficult to diagnose, possibly leading to delayed treatment and fatal complications.

Patients and methods: We present a case of a 73-year–old patient with Parkinson’s disease with complaints of severe epigastric pain, emesis and an increased lipase.

Results:

Diagnosis of an organo-axial gastric volvulus was made. Treatment consisted of reduction of the volvulus by decompression via nasogastric tube. The underlying cause was a para-esophageal hernia that was repaired by Nissen-fundoplication later on.

Conclusions: We describe symptomatology, diagnostic and therapeutic options of gastric volvulus.

Keywords:

• Acute gastric volvulus
• Borchardt’s triad
• epigastric pain
• surgery
• endoscopy
• lipase

Disclosure statement

No potential conflict of interest was reported by the authors.