A 68 year old female patient came to the E.D. with a chief complaint of sudden, severe epigastric pain, retching without vomitus and distention of the upper abdomen.
The patient was alert, very anxious, and in severe pain.
blood pressure of 160/120; pulse of 126; respiratory rate of 24; normal temperature; SatO2 of 96% without O2 supplement.
She had a distended upper abdomen and epigastric tenderness without rebound or guarding.
A plain film of the abdomen was ordered and showed gas-filled, grossly dilated stomach.
Pass of nasogastric tube was unsuccessful.
A laparotomy was mandatory.
The patient survived the surgery but 6 months later, she died by causes nonrelated to the surgery
In 1904, Borchardt described the classic triad of gastric volvulus: severe epigastric pain, retching without vomiting, and inability to pass a nasogastric tube.
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