Introduction: The aim of our work was to report a case of unclassifiable acute gastric volvulus due to diaphragmatic eventration in an adult treated in the general surgery department of the Ziguinchor Peace Hospital.

Case Report: This was a 52-year-old patient who had consulted for abdominal pain, associated with liquid vomiting and a stoppage of digestive transit. Her history was unremarkable. On physical examination, we noted a clear consciousness, a preserved general condition, a temperature of 37.8°C, a tachycardia of 101 beats/min, a blood pressure of 100/60 mmHg, a tympanic epigastric arch and peritoneal irritation. The attempt to place a nasogastric tube was laborious and brought back 150cc of blackish liquid. On biology, we noted a hyperleukocytosis with neutrophil predominance, a hemoglobin level of 10.6 g/dl, a creatinine level of 17.32 mg/l and an azotemia of 0.39 g/l. The computed tomography scan performed showed an elevation of the left diaphragmatic dome associated with marked gastric hydro-aeric distension and an area of tissue thickening, with vascular congestion, separating a purely hydro gastric contingent and another hydro-aeric contingent. Surgical exploration by laparotomy showed an unclassifiable gastric volvulus around the fundus engaged in a left diaphragmatic eventration. Gastric detorsion, atypical gastrectomy removing the necrotic fundus and phrenoplication were performed. The postoperative course was simple.

Conclusion: Acute gastric volvulus is a rare surgical emergency. The clinical signs are nonspecific and the diagnosis is most often radiological with CT. The treatment is surgical and consists of reduction, management of complications and treatment of the etiology with or without gastropexy