A twist in the tale

A 4-year-old girl presented with retching and abdominal colic and was initially diagnosed with gastroenteritis. However, progressive pain and epigastric distension led to a surgical review and she was discovered on CT scanning to have a gastric volvulus. She required urgent laparotomy to decompress the stomach and repair a perforation on the lesser curvature. Her recovery was complicated by sepsis and reperforation necessitating further laparotomy, at which time she also underwent gastropexy. The patient required long-term jejunal feeding in the hospital and at home before finally returning to normal diet and activity.