Gastric volvulus is a rare cause for upper digestive obstruction. It is potentially lethal and requires an urgent treatment. Its low frequency and non specific symptoms result in a late diagnosis, frequently leading to local or systemic complications. Its classic onset shows the Bortchard triad (epigastric pain, retching without vomitting and the impossibility to advance a nasogastric tube) which is observed in 70% of the patients. It is generally associated to anatomic alterations such as the hiatal hernia. A computed tomography scan is essential to complete the etiologic diagnosis. Surgical treatment intended for gastric devolvulation and to prevent recurrences, achieves good results and can be performed through a minimally invasive procedure.It is presented the case of a female patient with a gastric volvulus, diagnosed and treated laparoscopically in our Service.

Background: gallstone ileus is a rare complication of cholelithiasis. It is defined as a mechanical obstruction of the small bowel due to impaction of large gallstones into the gastrointestinal tract, generally though a cholecystoduodenal fistula. Rigler’s triad (pneumobilia, ectopic gallstone and mechanical obstruction) occurs in 30% of the patients. Surgery is indicated and includes enterotomy with gallstone extraction. Objective: we report a case of gallstone ileus with radiographic evidence of Rigler’s triad

Una propuesta de tríada diagnóstica a propósito de un caso de oclusión por fitobezoarUma proposta para uma tríade de diagnóstico em um caso de oclusão fitobezoar

Presentamos el caso de una paciente de sexo femenino de 81 años con un aceptable estado general, que consulta en la emergencia por dolor abdominal tipo cólico intenso acompañado de vómitos profusos de todo lo ingerido, sin bilis, de 5 días de evolución. Como antecedentes relevantes, la paciente refiere episodios similares en los últimos dos años, y ser portadora de una hernia hiatal.