Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe epigastric pain, persistent retching without emesis (Borchardtโs triad), and progressive abdominal distension. Symptoms are associated with sudden inability to pass nasogastric tube. No history of recent trauma or prior gastric surgery noted.
Clinical Examination Findings
Abdomen is markedly distended and tympanitic to percussion, particularly in the epigastric region. Bowel sounds are diminished or absent. Patient appears distressed, tachycardic, and tachypneic. Signs of hemodynamic instability or peritoneal irritation may be present depending on the duration of the volvulus.
Treatment Protocol
Immediate surgical consultation required. NPO status, aggressive fluid resuscitation, and nasogastric decompression attempt. Definitive management involves surgical detorsion of the stomach, often with gastropexy or repair of associated diaphragmatic defects. Monitor for signs of gastric ischemia or perforation.