The stomach rotates superiorly along its long access and is usually associated with a diaphragmatic defect.
The rotation causes a greater curvature of the stomach and must be equal or greater to 180° to be superior to the lesser curve as a result the stomach appears upside down.
60% of cases are organoaxial and 30% are mesenteroaxial, in which stomach rotates along its short axis.
The latter less common form of volvulus is usually associated with ligamentous laxity.
10% of cases are of a mixed tight.
Gastric volvulus can be classified additionally as subdiaphragmatic, or primary in 33% of cases and the cause of which is usually congenital or as supradiaphragmatic, or secondary in 67% of cases, and is generally caused by trauma or associated with diaphragmatic defects.
Patients with long-term gastric volvulus have dysphasia and intermittent abdominal pain often brought on by the ingestion of large meals.
Traumatic gastric volvulus is an emergent process and is associated with severe epigastric pain, inability to vomit, and difficult placement of a nasogastric tube-the combination known as Borchardt triad.
The process can develop into a closed-loop obstruction with incarceration, strangulation, ischemia, or gastric perforation.
Mortality in acute cases is 42-56% and then chronic cases 10-13%.