Post written by Harry R. Aslanian, MD, from Section of Digestive Diseases, Yale University School of Medicine, Yale University, New Haven, Connecticut, USA.

A middle-aged man presented with episodic dysphagia and weight loss. Radiologic interpretation of an upper GI series and CT scan were inconclusive. Prior EGD reported inability to pass the scope out of the stomach; however, subsequent EGD showed no obstruction. We demonstrate the endoscopic findings of a paraesophageal hernia with gastric volvulus and the change in endoscopic appearance with resolution of the volvulus.

Once seen and recognized, the swirling folds of the gastric body and occlusion of the proximal stomach by the associated volvulus are unmistakable; however, this is not commonly encountered. The typical findings on an upper GI series and CT were also presented. Prompt diagnosis and surgical correction can improve patient symptoms and prevent  incarceration of the gastric volvulus, which can be life-threatening.

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