Abstract:Gastric volvulus is a rare but potentially life-threatening condition. High index of suspicion is required in patients presenting with signs and symptoms suggestive of gastric outlet obstruction/Borchart's triad of epigastric pain and distension, retching or non-productive recurrent vomiting and difficulty in nasogastric tube insertion. We report a 14 year old young girl who presented in emergency department (ED) with signs of peritonitis and was later on diagnosed as acute gangrenous gastric volvulus. She was managed by immediate resuscitation, exploratory laparotomy and partial gastrectomy, anterior gastropexy and plication of diaphragm. Postoperative period was uneventful and patient was discharged on 6th postoperative day.