Gastric volvulus, a surgical or endoscopic emergency?

We present the case of a 62 year old male who presented to the emergency room with abdominal pain and vomiting in coffee grounds. In the diagnostic study, a gastric volvulus was detected and initial endoscopic management was decided. He presented a torpid clinical evolution, which eventually required surgical intervention as the final treatment. We highlight gastric volvulus as a rare urgent pathology, whose optimal management is still to be defined.