Gastric volvulus.

Gastric volvulus is a rare disease with an unknown incidence. Unless it stays in the back of the diagnostician's mind, diagnosis of gastric volvulus, which can have significant morbidity and mortality associated with it, can be easily missed. Unstable vital signs and distressed appearance are not always present, as in textbook cases. The presence of a hiatal hernia with persistent vomiting despite initial antiemetic treatment should trigger one to think of gastric volvulus, despite the patient appearing very stable. With the advent of CT and laparoscopic surgery, the gold standards for diagnosing and treating this disease are ever evolving.