Gastric Polyp: A rare cause of Chronic Volvulus in an Adult

Abstract

Gastric volvulus is a rare but potentially life-threatening cause of upper gastrointestinal obstruction. It presents clinically with epigastric pain radiating to the back and or left thoracic area or left abdominal quadrant and retching. This is a case of a 60 years old woman, who had a six-years history of an episodic epigastric pain related to meals. The pain was equally brought about by recumbence and relieved by decumbency. Three months prior to admission, her pain got worse and it was associated with vomiting. Abdominal ultrasound showed a gastric outlet soft tissue mass. Barium meal revealed a huge filling defect at the pyloric antrum. Oesophagogastrodudenoscopy showed a twisted gastric mucosa, brought about by a huge pedunculated gastric polyp. She was labelled to have a gastric volvulus and showed a good response to the conservative management. Surgical opinion was sought with the possibility of polypectomy and gastropexy. Surgery was postponed because she went into a hypertensive cardiac failure. We concluded that by twisting and de-twisting, gastric polyp may cause gastric volvulus that runs a chronic course. Therefore it has to be included in the differential diagnosis of chronic abdominal pain.

Key words: Gastric Volvulus, Gastric Polyp, Abdominal Pain, Sudan.