Acute primary gastric volvulus with open suture gastropexy: a case report.

Introduction and importance: Gastric volvulus is rare and may result in a closed-loop obstruction. Even with appropriate management, mortality may occur in up to 50% of patients. The conventional treatment for acute gastric volvulus has been immediate operation with reduction and detorsion of the volvulus.

Case presentation: Here, the authors present a case of acute gastric volvulus following fasting. The patient underwent definitive surgical treatment with detorsion and gastropexy, and was discharged with no postoperative complications.

Clinical discussion: Acute gastric volvulus is a rare yet serious medical condition that requires immediate diagnosis and intervention to prevent complications. The case presented highlights the importance of recognizing both common and subtle signs of gastric volvulus, though nonspecific symptoms may delay diagnosis. In this patient, the acute onset of symptoms following a large meal and failure to pass a nasogastric tube were early indicators that prompted imaging and led to the diagnosis of mesenteroaxial gastric volvulus. CT imaging played a crucial role in confirming the diagnosis, demonstrating its value in acute abdominal presentations where symptoms overlap with other causes of gastrointestinal obstruction. This case also emphasizes the importance of early intervention to avoid ischemic complications and improve survival rates.

Conclusion: Acute gastric volvulus is a rare, potentially life-threatening condition that can easily be missed due to nonspecific symptoms. Early recognition, prompt imaging, and immediate surgical intervention are critical to preventing serious complications such as strangulation and necrosis.