The term "gastric volvulus" is reserved for cases in which the abnormal rotation has led to strangulation and obstruction Gastric volvulus is defined as an abnormal rotation of the stomach of more than 180°, creating a closed loop obstruction that can result in incarceration and strangulation. The stomach can rotate along an axis that is 90° to the longitudinal axis. Such rotation is called a mesenteroaxial rotation. This rotation may lead to an upside-down stomach. Mesenteroaxial rotation of an intrathoracic stomach is less common than organoaxial rotation. Mesenteroaxial rotation is more frequently seen in patients with progression of a type 2 paraesophageal hiatal hernia.
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