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Ann Thorac Surg 2010;89:e15-e16. doi:10.1016/j.athoracsur.2009.12.026
© 2010 The Society of Thoracic Surgeons
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Case Reports

"Gastric Bascule": An Unusual Form of Gastric Volvulus

Amber Menezes, MDa, Leigh Sowerby, MDa, Richard A. Malthaner, MD, FRCS(C)b, Neil G. Parry, MD, FRCS(C)a,c,*

a Division of General Surgery, Department of Surgery, The University of Western Ontario, London, Ontario, Canada
b Division of Thoracic Surgery, Department of Surgery, The University of Western Ontario, London, Ontario, Canada
c Division of Critical Care, Department of Surgery, The University of Western Ontario, London, Ontario, Canada

Accepted for publication December 7, 2009.

* Address correspondence to Dr Parry, Department of Surgery, 800 Commissioners Rd E, PO Box 5010, London, ON N6A 5W9, Canada (Email: neil.parry{at}lhsc.on.ca).

Gastric volvulus can occur along the organoaxial axis or the mesenteroaxial axis. We present a patient with a gastric bascule: a gastric volvulus due to two lead points. A 17-year-old boy with dextrogastria, asplenia, and left diaphragmatic eventration presented with acute onset of nonbilious emesis, jaundice, and diffuse abdominal tenderness. Surgical exploration demonstrated a gastric volvulus, with lead points of torsion at the gastroesophageal junction and the second part of the duodenum, causing biliary obstruction. After decompression, reduction, and gastropexy, the patient recovered well. Gastric bascule is a subtype of gastric volvulus, whereby two lead points cause gastric rotation and folding of the stomach upon itself.






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