Pediatric Organoaxial Gastric Volvulus

Etiology:
— Stomach twists on its mesentery and stomach is rotated along its long axis
— Often associated with diaphragmatic defect
Imaging UpperGI: Mirror image of normal anatomy with reversal of the greater and lesser curvatures
Note: Greater curvature of stomach should never be above lesser curvature of stomach
DDX:
Complications:
Treatment:
Clinical: Borchardt triad – sudden epigastric pain, intractable retching, inability to pass nasogastric tube into stomach

Radiology Cases of Organoaxial Gastric Volvulus

Upper GI of organoaxial gastric volvulus — Early AP (above left) and later AP (above right) and lateral (below) images from an upper GI shows rotation of the stomach along its long axis with reversal of the greater and lesser curvatures of the stomach.

Upper GI of organoaxial gastric volvulus and hiatal hernia — Early AP (above left) and later AP (above right) and lateral (below) images from an upper GI shows rotation of the stomach along its long axis with reversal of the greater and lesser curvatures of the stomach. The stomach is also noted to have slid through the esophageal hiatus into the chest.

Upper GI of organoaxial volvulus — AP image from an upper GI shows rotation of the stomach along its long axis with reversal of the greater and lesser curvatures of the stomach.