Gastric volvulus: an old disease process with some new twists.

Gastric volvulus has been described in the medical literature for centuries. The acute presentation of gastric volvulus is dramatic and not often missed, and it is this type that is usually quoted in the literature and case citations. The subacute or chronic type, however, is frequently not recognized early in its presentation because it is accompanied by vague and nonspecific symptomatology suggestive of other abdominal processes. We review the classification, diagnosis, and treatments of gastric volvulus and highlight the significance of the chronic volvulus presentation through case descriptions, including endoscopic and radiographic features.