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Gastric Volvulus Treatment | Pristyn Care

Gastric volvulus is a rare but life-threatening rotation of the stomach causing obstruction. Pristyn Care offers emergency and elective laparoscopic repair with gastropexy or fundoplication.

Gastric volvulus is a rare but life-threatening rotation of the stomach causing obstruction. ... Read More

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    Dr. Galla Murali Mohan - A general-surgeon for Hernia

    Dr. Galla Murali Mohan

    MBBS, MS-General Surgery
    34 Yrs.Exp.

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    location icon Pristyn Care Archana Hospital, Madeenaguda, Hyderabad
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    Dr. Vipin Nagpal - A general-surgeon for Hernia

    Dr. Vipin Nagpal

    MBBS, MS-General Surgery
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    31 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
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    Dr. Rakesh Shivhare - A general-surgeon for Hernia

    Dr. Rakesh Shivhare

    MBBS, MS(GI & General Surgeon)
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    location icon Opp.Badwani Plaza, Manorama Ganj, Old Palasia, Indore, Madhya Pradesh 452003
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    Dr. Apoorv Shrivastava - A general-surgeon for Hernia

    Dr. Apoorv Shrivastava

    MBBS, DNB-General Surgery
    25 Yrs.Exp.

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    25 Years Experience

    location icon Pristyn Care Eminent Hospital 6/1 Opp. Barwani Plaza, Manorama Ganj, Old Palasia, Indore - 452018
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About Gastric Volvulus

Gastric volvulus is an abnormal rotation of the stomach by more than 180 degrees around its own axis, causing obstruction and potential ischaemia. It may be acute (surgical emergency with strangulation risk) or chronic (intermittent episodes of pain and vomiting). It is commonly associated with large paraesophageal hernias and diaphragmatic defects.

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Symptoms

Symptoms of gastric volvulus include:

  • Sudden severe upper abdominal or chest pain
  • Unproductive retching with inability to vomit (Borchardt’s triad)
  • Inability to pass a nasogastric tube in acute cases
  • Abdominal distension and tympany
  • Dysphagia and regurgitation in chronic cases
  • Cardiovascular collapse in strangulated volvulus (emergency)
  • Intermittent epigastric pain and early satiety in organoaxial chronic type

Are you going through any of these symptoms?

Causes

Gastric volvulus is caused by:

  • Large paraesophageal or diaphragmatic hernia (most common cause)
  • Absent or lax gastrosplenic and gastrophrenic ligaments
  • Adhesions from previous surgery
  • Wandering spleen or asplenia
  • Congenital diaphragmatic defects
  • Eventration of the diaphragm

Types of Gastric Volvulus

Classification by axis of rotation:

  • Organoaxial volvulus: rotation along long axis of stomach (most common, associated with PEH)
  • Mesenteroaxial volvulus: rotation perpendicular to long axis (more common in children)
  • Combined volvulus: rotation along both axes simultaneously
  • Acute volvulus: surgical emergency with risk of ischaemia
  • Chronic volvulus: recurrent intermittent episodes

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Risk Factors

Risk factors include:

  • Large paraesophageal or diaphragmatic hernia
  • Prior splenectomy (loss of gastrosplenic ligament)
  • Lax gastric ligaments (congenital or acquired)
  • Previous upper abdominal surgery
  • Eventration of the left hemidiaphragm
  • Elderly patients with diaphragmatic weakness

Who Is at Risk

Elderly patients with large hiatal or diaphragmatic hernias, prior splenectomy, or congenitally lax gastric ligaments are at highest risk. Gastric volvulus is rare but life-threatening in its acute form.

Diagnosis

Diagnostic evaluation includes:

  • Chest X-ray showing air-fluid level in chest or inverted stomach
  • CT abdomen-chest showing rotated stomach and hernia contents
  • Barium swallow (in chronic cases) showing the volvulus anatomy
  • Upper GI endoscopy (if feasible) to assess mucosal viability
  • Nasogastric tube passage attempt (often fails in acute cases)

Treatment for Gastric Volvulus

Pristyn Care manages acute gastric volvulus with emergency laparoscopic detorsion and repair, and elective cases with laparoscopic reduction of hernia, gastropexy, and fundoplication to prevent recurrence.

Laparoscopic Repair Procedure

Procedure involves:

  • Emergency cases: nasogastric decompression followed by laparoscopic detorsion
  • Reduction of herniated stomach and organs into the abdomen
  • Resection of ischaemic gastric tissue if necrosis present (rare)
  • Repair of diaphragmatic defect or hiatal hernia
  • Anterior gastropexy (fixation of stomach to anterior abdominal wall)
  • Fundoplication to prevent recurrent volvulus and GERD
  • Assessment of spleen and surrounding structures

After the Surgery

Post-operative care includes:

  • Nasogastric tube decompression for 24-48 hours post-op
  • Liquid diet progressing to soft diet over 4-6 weeks
  • Proton pump inhibitor therapy for 3-6 months
  • Barium swallow at 6 weeks to confirm stomach position
  • Avoidance of heavy lifting for 6-8 weeks
  • Long-term follow-up for hernia recurrence surveillance

Possible Complications of Gastric Volvulus Surgery

Potential complications include:

  • Gastric ischaemia requiring partial gastrectomy (in delayed presentation)
  • Oesophageal or gastric perforation during reduction
  • Recurrent volvulus if gastropexy fails
  • Dysphagia from fundoplication
  • Pleural injury causing pneumothorax
  • Post-operative ileus and slow gastric emptying

Frequently Asked Questions

Is gastric volvulus a medical emergency?

Acute gastric volvulus with strangulation is a surgical emergency requiring immediate laparoscopic or open repair to prevent gastric necrosis. Chronic volvulus can be managed electively but should not be ignored.

What is Borchardt's triad in gastric volvulus?

Borchardt’s triad is the classic presentation of acute gastric volvulus: severe epigastric pain, unproductive retching, and inability to pass a nasogastric tube. It is pathognomonic of acute gastric volvulus.

Can gastric volvulus recur after surgery?

Recurrence is uncommon after laparoscopic repair with gastropexy and fundoplication. The recurrence rate is approximately 5-10% at 5 years, usually due to hernia recurrence or gastropexy failure.

What is the difference between gastric volvulus and hiatal hernia?

A hiatal hernia is the herniation of the stomach into the chest through the oesophageal hiatus. Gastric volvulus is the abnormal rotation of the stomach (which may occur inside or outside a hernia), causing obstruction and potential strangulation.

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Medically Reviewed By
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Dr. Galla Murali Mohan
MBBS, MS-General Surgery
34 Years Experience Overall
Last Updated : April 29, 2026

What Our Patients Say

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    Subrata Chatterjee

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    Very good experience. Doctor is very helpful and also has done a great job handling the patient and calming the patient and spreading a positive vibe. Thanks Doctor.

    City : Delhi
    Treated by : Dr. Daipayan Ghosh
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    Varalakshmi

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    Dr. Vikranth Suresh explained the umbilical hernia condition very clearly and patiently answered all our questions. He made us feel comfortable and confident about the treatment. The overall experience with Pristyn Care was smooth and well coordinated. Thank you for the good support.

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    Procedure was safe, healing is going well, and overall experience was excellent.

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    Dr Ranjith is very knowledgeable and patient enough to answer any questions asked. Very camly he clears all the doubts and will in hurry or rush.

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    Hernia operation went well, pain is reducing , and hospital experience was good.

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    Mariappan, 39 Yrs

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    I recently underwent hernia surgery under Dr. Abhilash Madhavan, and I am extremely satisfied with the treatment. The doctor explained the condition, surgery procedure and recovery plan very clearly, which gave me full confidence before the operation. The surgery went smoothly and my recovery has been excellent. Till the bandage removal, the support and follow-up from the doctor and medical team were very good. I would like to give special appreciation to Mr. Arun from Pristyn Care – Medical Counsellor. He guided me from the very beginning, answered all my queries with patience and made sure I was mentally comfortable before and after the surgery. His continuous support truly made the experience easier. Overall, I am very happy with the outcome of my surgery. My sincere thanks to Dr. Abhilash Madhavan, Mr. Arun from Pristyn Care, and the entire team for their dedication and care. I definitely recommend them for hernia treatment.

    City : Chennai
    Treated by : Dr. Abilash M