Acute gastric volvulus is a rare yet life threatening condition with mortality ranging from 30% to 50% if not treated promptly. The stomach rotates on itself, causing strangulation precipitating necrosis, cameron lesions and perforation. Long-standing paraesophageal hernia is a common cause of organoaxial gastric volvulus.

Dobhoff tubes, used for post-pyloric feedings, have a weighted metal end with a small diameter that enhances their flexibility to traverse the gastrointestinal tract. Unfortunately, the metal stylet can iatrogenically perforate surrounding structures in patients with diminished cough and gag (1); and extreme caution should be considered before its utilization.