Presentation
Progressive dysphagia and a history of a long known untreated hiatus hernia.
Patient Data
Large retrocardiac mass with air-fluid level.
Pulmonary findings suggest COPD.
Large hiatal hernia associated with inversion of the greater and lesser curvatures.
Gastroesophageal reflux is also observed.
Case Discussion
Relatively rare clinical syndrome characterized by torsion of part or all of the stomach. It can occur at any age. The most significant single associated condition is gastric herniation either through the esophageal hiatus or a diaphragmatic defect. There are two types: organoaxial, in which the stomach rotates along its long axis, and mesenteroaxial, rotating along a short axis joining the greater and lesser curvatures.
This case presents the typical patient with an organoaxial volvulus: elderly with progressive dysphagia and a long history of neglected hernia.