An acute gastric volvulus in a child with congenital left diaphragmatic hernia: a case report

BMC Pediatr. 2024 May 20;24(1):348. doi: 10.1186/s12887-024-04834-8.


Background: Acute complete gastric volvulus is a rare and life-threatening disease, which is prone to gastric wall ischemia, perforation, and necrosis. If it is not treated by surgery in time, the mortality rate can range from 30 to 50%. Clinical presentations of acute gastric volvulus are atypical and often mimic other abdominal conditions such as gastritis, gastroesophageal reflux, gastric dilation, and pancreatitis. Imaging studies are crucial for diagnosis, with barium meal fluoroscopy being the primary modality for diagnosing gastric volvulus. Cases of acute gastric volvulus diagnosed by ultrasound are rarely reported.

Case presentation: We reported a rare case of acute gastric volvulus in a 4-year-old Chinese girl who presented with vomiting and abdominal pain. Ultrasound examination revealed the "whirlpool sign" in the cardia region, raising suspicion of gastric volvulus. Diagnosis was confirmed by X-ray barium meal fluoroscopy, which indicated left-sided diaphragmatic hernia and obstruction at the cardia region. Surgical intervention confirmed our suspicion of acute complete gastric volvulus combined with diaphragmatic hernia.

Conclusion: In this case, we reported an instance of acute complete gastric volvulus. Ultrasound revealed a "whirlpool sign" in the cardia, which is likely to be a key sign for the diagnosis of complete gastric volvulus.

Keywords: Acute gastric volvulus; Children; Ultrasound; Whirlpool sign.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Child, Preschool
  • Female
  • Fluoroscopy
  • Hernias, Diaphragmatic, Congenital* / complications
  • Hernias, Diaphragmatic, Congenital* / diagnostic imaging
  • Hernias, Diaphragmatic, Congenital* / surgery
  • Humans
  • Stomach Volvulus* / complications
  • Stomach Volvulus* / diagnosis
  • Stomach Volvulus* / diagnostic imaging
  • Stomach Volvulus* / surgery
  • Ultrasonography