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Case Reports in Medicine
Volume 2014, Article ID 136381, 3 pages
http://dx.doi.org/10.1155/2014/136381
Case Report

Successful Gastric Volvulus Reduction and Gastropexy Using a Dual Endoscope Technique

1Division of Digestive Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA
2Department of Medicine, Cedars Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA
3Department of Gastroenterology, University of Southern California, Los Angeles, CA, USA

Received 16 September 2013; Accepted 10 November 2013; Published 19 January 2014

Academic Editor: William B. Silverman

Copyright © 2014 Laith H. Jamil et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastric volvulus is a life threatening condition characterized by an abnormal rotation of the stomach around an axis. Although the first line treatment of this disorder is surgical, we report here a case of gastric volvulus that was endoscopically managed using a novel strategy. An 83-year-old female with a history of pancreatic cancer status postpylorus-preserving Whipple procedure presented with a cecal volvulus requiring right hemicolectomy. Postoperative imaging included a CT scan and upper GI series that showed a gastric volvulus with the antrum located above the diaphragm. An upper endoscopy was advanced through the pylorus into the duodenum and left in this position to keep the stomach under the diaphragm. A second pediatric endoscope was advanced alongside and used to complete percutaneous endoscopic gastrostomy (PEG) placement for anterior gastropexy. The patient’s volvulus resolved and there were no complications. From our review of the literature, the dual endoscopic technique employed here has not been previously described. Patients who are poor surgical candidates or those who do not require emergent surgery can possibly benefit the most from similar minimally invasive endoscopic procedures as described here.