Gastric organoaxial volvulus: A lethal twist and a rare cause of acute abdomen

Organoaxial gastric volvulus is a rare clinical condition. We present a 55 years old man with an acute episode of melena and hematemesis with moderate epigastric pain which was unresponsive to analgesics. Initially, the patient was misdiagnosed and treated symptomatically for other gastrointestinal conditions but later contrast-enhanced abdominal CT scan revealed gastric organo-axial volvulus, which was associated with a right hiatal hernia. The patient underwent surgical treatment, including crural dissection, posterior esophageal window creation, lower esophageal sling, crural defect repair with porcine meshes, and anterior gastropexy, followed by intensive physiotherapy and antibiotics. Diagnosis of gastric volvulus can be challenging, due to its symptom similarity to other gastrointestinal disorders, necessitating a high level of suspicion.