title: Acute gastric volvulus: A vicious twist of tummy-case report.
abstract: BACKGROUND
  Gastric volvulus is an uncommon disorder and can present either in the acute or chronic setting with variable symptoms. A robust blood supply of the stomach from different sources does not allow ischemia to develop early. When it occurs in the acute scenario, patients present with severe epigastric pain and retching without vomiting. Together with inability to pass nasogastric tube, they constitute Borchardt's triad.
  
  
  METHODS
  We report a case which presented in the emergency department with severe abdominal pain, abdominal distension and vomiting and a previous history of pulmonary tuberculosis. An incidental finding of uterovaginal prolapse was present. A diagnosis of acute gastric volvulus with peritonitis was made and total gastrectomy with Roux-en-Y esophagojejunostomy for gangrenous and perforated stomach was performed.
  
  
  CONCLUSIONS
  Primary gastric volvulus occurs in the absence of any defect in the diaphragm or adjacent organ pathology and may be caused by weakening of gastric supports. We wish to highlight if there is a possible association of primary gastric volvulus with uterovaginal prolapse reflecting a general laxity of body ligaments or with fibrosis of the lung secondary to pulmonary tuberculosis resulting into the twisting of the stomach.
  
  
  CONCLUSIONS
  Acute gastric volvulus is a surgical emergency requiring early diagnosis and aggressive management, as a delay results into complications like gangrene and perforation which substantially increase the morbidity and mortality in these patients.
authors.affiliation: Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India. Electronic address: jha.basudev87@gmail.com.
authors.forename: Basudev
authors.initials: B
authors.lastname: Kumar
authors.affiliation: Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India. Electronic address: drtk2014@gmail.com.
authors.forename: Tarun
authors.initials: T
authors.lastname: Kalra
authors.affiliation: Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India. Electronic address: ratnakarnamdeo@gmail.com.
authors.forename: Ratnakar
authors.initials: R
authors.lastname: Namdeo
authors.affiliation: Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India. Electronic address: sonirajesh79@yahoo.co.in.
authors.forename: Rajesh Kumar
authors.initials: RK
authors.lastname: Soni
authors.affiliation: Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India. Electronic address: dr.sinha.ajit@gmail.com.
authors.forename: Ajit
authors.initials: A
authors.lastname: Sinha
keywords: Acute gastric volvulus; Borchardt’s triad; Gastric gangrene; Organoaxial; Primary gastric volvulus; Total gastrectomy