Zhang Q, Xu XJ, Ma J, Huang HY, Zhang YM. Acute gastric volvulus combined with pneumatosis coli rupture misdiagnosed as gastric volvulus with perforation: A case report. World J Gastrointest Surg 2024; 16(10): 3350-3357 [DOI: 10.4240/wjgs.v16.i10.3350]
Corresponding Author of This Article
Ya-Ming Zhang, Doctor, MD, PhD, Chief Physician, Professor, Department of General Surgery, Anqing Municipal Hospital, No. 352 Renmin Road, Anqing 246000, Anhui Province, China. zhangyaming2014@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3350-3357 Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3350
Acute gastric volvulus combined with pneumatosis coli rupture misdiagnosed as gastric volvulus with perforation: A case report
Qi Zhang, Xiu-Juan Xu, Jun Ma, Hai-Ying Huang, Ya-Ming Zhang
Qi Zhang, Jun Ma, Ya-Ming Zhang, Department of General Surgery, Anqing Municipal Hospital, Anqing 246000, Anhui Province, China
Xiu-Juan Xu, Department of Critical Medicine, Anqing Municipal Hospital, Anqing 246000, Anhui Province, China
Hai-Ying Huang, Department of Gastroenterology, Anqing Municipal Hospital, Anqing 246000, Anhui Province, China
Co-first authors: Qi Zhang and Xiu-Juan Xu.
Author contributions: Zhang Q and Huang HY completed the surgery; Zhang YM and Ma J revised the article; Zhang Q and Xu XJ wrote the manuscript. All authors have read and approved the final manuscript. Zhang Q and Xu XJ contributed equally to this work as co-first authors.
Informed consent statement: Written informed consent was obtained from the patient to publish this paper.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Ming Zhang, Doctor, MD, PhD, Chief Physician, Professor, Department of General Surgery, Anqing Municipal Hospital, No. 352 Renmin Road, Anqing 246000, Anhui Province, China. zhangyaming2014@163.com
Received: July 8, 2024 Revised: August 22, 2024 Accepted: August 29, 2024 Published online: October 27, 2024 Processing time: 81 Days and 2.9 Hours
Abstract
BACKGROUND
Acute gastric volvulus represents a rare form of surgical acute abdomen, which makes it difficult to establish an early diagnosis. As the disease progresses, it can lead to gastric ischemia, necrosis, and other serious complications.
CASE SUMMARY
This paper reports a 67-year-old female patient with a history of abdominal distension and retching for 1 day. After admission, a prompt and thorough examination was performed to confirm the diagnosis of acute gastric volvulus. Notably, the patient had free air in the abdominal cavity. The first consideration was gastric volvulus with gastric perforation, but the patient had no complaints, such as abdominal pain or signs of peritoneal irritation in the abdomen, and imaging examination revealed no abdominal pelvic effusion. Following endoscopic reduction, the abdominal organs, such as the stomach and spleen, returned to their normal anatomical positions, and the free intraperitoneal air disappeared, suggesting a rare case of acute gastric torsion. The source of free air within the abdominal cavity warrants careful consideration and discussion. Combined with the findings from computed tomography, these findings are hypothesized to be associated with the rupture of colonic air cysts.
CONCLUSION
Patients with gastric torsion combined with free gas in the abdominal cavity should consider nongastrointestinal perforation factors to avoid misdiagnosis.
Core Tip: In this case, a 67-year-old female was admitted to the hospital due to abdominal distension and pain. The initial diagnosis was acute gastric torsion accompanied by free gas in the abdominal cavity. This makes it easy for us to determine the presence of gastric perforation. However, the patient's physical examination and abdominal computed tomography (CT) scan did not support the diagnosis of gastric perforation. After endoscopic reduction of gastric torsion, we found that the patient also had a colonic gas cyst after reexamination via CT. This is a rare case that has not been reported before.
