When performing endoscopic reduction in patients with
gastric volvulus, it is important to maintain a low level of intragastric pressure and to fix the
endoscope in the duodenum. Gel immersion endoscopy is a new method for securing the visual field by injecting clear gel. The balloon-attached
endoscope makes it easier to fix the tip in the duodenum without mucosal damage. We report successful reduction of a mesenteroaxial
gastric volvulus using an
endoscope with a balloon in combination with gel immersion endoscopy. A 3-year-old Japanese male developed
gastric volvulus. Since gastric
decompression using a nasogastric tube failed to reduce the
volvulus, endoscopic reduction was performed under
general anesthesia. After aspiration of intragastric gas, clear gel was injected through the accessory channel which secured the visual field in the stomach even with residue while maintaining low intragastric pressure. After reaching the descending portion of the duodenum, the balloon attached to the tip of the
endoscope was inflated and fixed in the duodenum. The
volvulus was successfully reduced by pulling back the
endoscope with clockwise torque. Acute mesenteroaxial
gastric volvulus has the potential to cause
ischemia and perforation which can be life-threatening, so most patients are treated with surgical intervention. Gel immersion endoscopy is safe and effective to secure the visual field, even in children. Endoscopic reduction may be a viable treatment option for reducing
gastric volvulus in non-emergent patients.