Small bowel volvulus resulting in infarction due to an anterior gastropexy band

Volvulus of the small bowel, although rare, carries a high risk of strangulation and ischemic necrosis. It is usually caused by the rotation of a loop of small intestine around an adhesion band or stoma. We present a case of an anterior gastropexy band, giving rise to a small bowel volvulus, necessitating resection due to infarction. This band resulted from separation of the most distal anterior gastropexy suture from the anterior abdominal wall. The distensible nature of the stomach and its resultant postprandial gain in weight produced tremendous shearing forces on the gastropexy sutures, and, as our case demonstrates, a greater number of gastropexy sutures does not protect against this complication.