Cureus
. 2026 Mar 1;18(3):e104489.
doi: 10.7759/cureus.104489. eCollection 2026 Mar. https://pubmed.ncbi.nlm.nih.gov/41924659/
Secondary Mesenteroaxial Gastric Volvulus in an Elderly Female: A Rare Presentation of an Occult Diaphragmatic Hernia
Rajahamsa Ravala 1, Surendran Paramsivam 1, Manish Marlecha 1, Muthurenganathan Pl 1
Affiliations Expand
- PMID: 41924659
- PMCID: PMC13038051
- DOI: 10.7759/cureus.104489
Abstract
Gastric volvulus is a surgical emergency characterized by rotation of the stomach greater than 180°, potentially leading to ischemia and perforation. Mesenteroaxial volvulus associated with a late-presenting diaphragmatic hernia in adults is an uncommon clinical entity. A 70-year-old woman with diabetes presented with acute abdominal distension and lactic acidosis. Nasogastric decompression yielded 3 L of coffee-ground aspirate, and computed tomography (CT) identified a mesenteroaxial gastric volvulus. Emergency laparotomy revealed a left-sided diaphragmatic hernia containing the gastric antrum and pylorus. Management included detorsion, reinforcement of a focal ischemic area on the posterior gastric wall, diaphragmatic repair, and gastropexy. This case highlights the silent nature of congenital diaphragmatic defects in the elderly, which can present as life-threatening acute scenarios. It emphasizes the importance of immediate and adequate resuscitative measures, coupled with early diagnosis and definitive treatment.
Keywords: acute abdomen; diaphragmatic hernia; gastric volvulus; gastropexy; mesenteroaxial gastric volvulus.
Copyright © 2026, Ravala et al.
About The Author
