Diaphragmatic Hernia Presenting as a Gastric Volvulus

Gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach and it presents with the features of gastric outlet obstruction. The precipitating factors are usually idiopathic or due to abnormal laxity of the gastrosplenic, gastroduodenal, gastrophrenic and gastrohepatic ligaments or in cases of paraesophageal hernias. In adults, the most common causes of gastric volvulus are the diaphragmatic defects. We present a case of a 65 yrs old lady, who came with the symptoms of gastric outlet obstruction, which on initial investigation pointed towards the diagnosis of a gastric volvulus. On laprotomy, the stomach was found to be incarcerated in a right-sided Morgagni hernia with surrounding adhesions. The hernia through the foramen of the Morgagni is uncommon in adults, accounting for only 3% of all the treated diaphragmatic hernias. The treatment for these hernias primarily is surgical repair or sometimes, repair by the use of prosthetic material. We report a rare case of a Morgagni hernia presenting as gastric volvulus.