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Updated: Nov 21, 2025
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Published on: September 22, 2023
Gastric necrosis following a hiatal hernia: A case report
Gregoire Longchamp1, Axel Andres1, Ziad Abbassi1
1Division of Digestive Surgery, University Hospitals of Geneva, 1205, Geneva, Switzerland.
Introduction:
Gastric volvulus are rare. Complications can be life threatening, including necrosis and perforation. Assessment of mucosal viability is essential, and urgent surgical intervention is mandatory in case of vascular compromise.
Presentation Of Case:
An 72-year-old female known for a paraesophageal hiatal hernia was admitted at our emergency department with acute abdominal pain. Blood count demonstrated leukocytosis and increased C-reactive protein. Abdominal computed tomography showed a mesenteroaxial gastric volvulus. Urgent upper endoscopy revealed mucosal ischemia, which prompted immediate laparotomy with partial gastrectomy, cruroplasty, and Dor fundoplication. Postoperative course was uneventful.
Discussion:
Gastric volvulus is initially treated with nasogastric tube decompression, but definitive treatment is achieved surgically. When there is an associated hernia, closing the anatomical defect and fundoplication should be performed. Complication such as necrosis is associated with a high mortality, and requires urgent surgical repair.
Conclusion:
Gastric volvulus can be life-threatening. Urgent endoscopic or surgical assessment should be conducted to assess mucosal viability.
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