A 55-year-old woman presented with sudden onset upper abdominal pain and vomiting. On examination she had tender epigastric mass with "succusion splash" on auscultation. Straight abdominal x ray showed a distended and displaced stomach with another gas filled viscus around it. Subsequent computed tomography suggested caecal volvulus herniated through the epiploic foramen obstructing the gastric outlet. The patient underwent reduction of the internal hernia and right hemicolectomy. Postoperative recovery was uneventful. Herniation of caecal volvulus through the epiploic foramen is a very rare condition and its presentation as a gastric outlet obstruction has not been reported before.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028251PMC
http://dx.doi.org/10.1136/bcr.05.2009.1880DOI Listing

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