Organoaxial Volvulus

An elderly woman was seen in the Gastroenterology Clinic to evaluate 6 months of weekly episodic, left-sided, postprandial abdominal pain with nausea. Episodes typically lasted 30 minutes. The pain did not occur with every meal, and improved after emesis. Between episodes she was asymptomatic. Examination and laboratory results were unremarkable. She underwent small-bowel follow-through, which captured an episode of stomach herniation with organoaxial volvulus (Figure A). The stomach herniated into the thorax and rotated along the cardiopyloric axis of the stomach (Figure B, dashed line).

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