title: Delayed diaphragmatic rupture presenting with acute gastric volvulus.
abstract: Gastric volvulus is a rare complication of diaphragmatic rupture. We report the case of an 82-year-old man who presented following an out-of-hospital cardiac arrest. Chest radiography and thoracic computed tomography revealed an acute gastric volvulus and a chronic diaphragmatic hernia containing transverse colon and abdominal viscera. He had complained of retching and associated epigastric pain prior to collapse, and had sustained a motorcycle accident approximately 60 years earlier. Insertion of a nasogastric tube was unsuccessful (completing Borchardt's diagnostic triad) and his condition prevented both operative and endoscopic reduction of his volvulus. He died soon afterwards.
authors.affiliation: University Hospitals Bristol NHS Foundation Trust, UK.
authors.forename: J M L
authors.initials: JM
authors.lastname: Williamson
authors.forename: R
authors.initials: R
authors.lastname: Macleod
authors.forename: A
authors.initials: A
authors.lastname: Hollowood
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006548:Hernia, Diaphragmatic / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest; D013902:Radiography, Thoracic / Q000379:methods; D012422:Rupture, Spontaneous / Q000175:diagnosis; D013277:Stomach Volvulus / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods