IntroductionGastric volvulus is an uncommon but potentially life-threatening condition characterized by the abnormal twisting of the stomach along its axes, leading to obstruction and compromised blood flow (ischemia)1,2. Initially described by Berti in 1866, this disorder poses significant diagnostic and therapeutic challenges due to its broad spectrum of clinical presentations 3,4. There is no gender predilection, and the highest incidence is observed in individuals in their fifth decade of life, with a secondary peak in infants under one year of age 3. Predisposing factors include diaphragmatic defects such as hiatal or paraesophageal hernias, phrenic nerve dysfunction, congenital anomalies of the stomach or spleen, a history of bariatric surgery, and spinal deformities like kyphoscoliosis 2,3,5.The clinical manifestations of gastric volvulus are highly variable, ranging from vague abdominal discomfort to acute abdominal emergencies, complicating timely diagnosis 2. A classic presentation includes Borchardt’s triad, which is present in 70% of the cases. It is defined as severe epigastric pain, unproductive retching, and the inability to pass a nasogastric tube 6,7. Etiologically, gastric volvulus can be classified as primary, resulting from congenital or acquired abnormalities in the gastric suspensory ligaments, or more commonly as secondary, associated with other anatomical defects such as diaphragmatic hernias 2,5.Intestinal obstruction is the primary complication, which can manifest acutely, recurrently, intermittently, or chronically8. Additionally, the risk of gastric strangulation can lead to severe outcomes, including gastric tissue necrosis, perforation, sepsis, hypovolemic shock, displacement of the other internal organs, and aspiration pneumonia 1,5,8,9. Diagnosis based on the history or physical examination is challenging, and the confirmation typically relies on radiological imaging, with plain radiographs, computed tomography (CT) scans, and upper gastrointestinal series playing crucial roles 5,6. Once diagnosed, surgical intervention is generally the preferred treatment approach8,10.Given the significant morbidity and mortality rates linked to gastric volvulus, early recognition and prompt management are critical. This case series highlights two patients diagnosed with gastric volvulus, illustrating the diverse clinical presentations, diagnostic challenges, and treatment approaches associated with this rare condition.