Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Introduction: Gastric volvulus, a rare condition in which the stomach rotates along its anatomical axis, can present as a medical emergency in infants. In both acute and chronic forms of gastric volvulus, the condition often presents with nonspecific gastrointestinal symptoms, such as abdominal pain and nonbilious emesis, which can lead to the misdiagnosis of gastroesophageal reflux disease (GERD). Congenital defects, such as diaphragmatic hernia, or weakness of the gastric supporting ligaments, can predispose infants to gastric volvulus. Lack of timely intervention may lead to failure to thrive, gastric ischemia, and obstruction.
Case presentation: A 5-month-old full-term female infant presented to the emergency department with failure to thrive following several months of recurrent nonbilious vomiting that had escalated in frequency. Two months prior, following an episode of brown and bloody emesis, the patient’s symptoms were initially attributed to GERD. She had been exclusively breastfed since birth, and the mother denied any issues with latching and swallowing. On initial presentation, she showed signs of dehydration with a BUN/Creatinine ratio of 35 and an elevated bicarbonate level of 29 mmol/L, suggestive of metabolic alkalosis. Final Diagnosis: On initial presentation, a KUB showed an unremarkable bowel gas pattern with no evidence of free intraperitoneal air. A small bowel follow-through fluoroscopic study later revealed the stomach in the right upper thorax, confirming the diagnosis of gastric volvulus.
Management/Outcome: Prior to surgical reduction of the volvulus, the infant was given intravenous pantoprazole and dextrose-containing fluids. The volvulus was managed with gastropexy and gastrostomy tube placement. By postoperative day 3, the patient tolerated breastfeeding, and she no longer required intravenous fluids. She was discharged on postoperative day 4. At 6-week follow-up, the patient’s mother denied further emesis episodes, and the infant showed adequate weight gain. In conclusion, the diagnosis of gastric volvulus must be considered in infants who present with failure to thrive and symptoms mimicking gastroesophageal reflux disease.
Embargo Period
6-1-2026
Included in
Gastric Volvulus in an Infant: A Rare Medical Emergency
Suwanee, GA
Introduction: Gastric volvulus, a rare condition in which the stomach rotates along its anatomical axis, can present as a medical emergency in infants. In both acute and chronic forms of gastric volvulus, the condition often presents with nonspecific gastrointestinal symptoms, such as abdominal pain and nonbilious emesis, which can lead to the misdiagnosis of gastroesophageal reflux disease (GERD). Congenital defects, such as diaphragmatic hernia, or weakness of the gastric supporting ligaments, can predispose infants to gastric volvulus. Lack of timely intervention may lead to failure to thrive, gastric ischemia, and obstruction.
Case presentation: A 5-month-old full-term female infant presented to the emergency department with failure to thrive following several months of recurrent nonbilious vomiting that had escalated in frequency. Two months prior, following an episode of brown and bloody emesis, the patient’s symptoms were initially attributed to GERD. She had been exclusively breastfed since birth, and the mother denied any issues with latching and swallowing. On initial presentation, she showed signs of dehydration with a BUN/Creatinine ratio of 35 and an elevated bicarbonate level of 29 mmol/L, suggestive of metabolic alkalosis. Final Diagnosis: On initial presentation, a KUB showed an unremarkable bowel gas pattern with no evidence of free intraperitoneal air. A small bowel follow-through fluoroscopic study later revealed the stomach in the right upper thorax, confirming the diagnosis of gastric volvulus.
Management/Outcome: Prior to surgical reduction of the volvulus, the infant was given intravenous pantoprazole and dextrose-containing fluids. The volvulus was managed with gastropexy and gastrostomy tube placement. By postoperative day 3, the patient tolerated breastfeeding, and she no longer required intravenous fluids. She was discharged on postoperative day 4. At 6-week follow-up, the patient’s mother denied further emesis episodes, and the infant showed adequate weight gain. In conclusion, the diagnosis of gastric volvulus must be considered in infants who present with failure to thrive and symptoms mimicking gastroesophageal reflux disease.
Comments
Awarded "Best Clinical Case Study" at PCOM Georgia Research Day 2026.