Abdominal and GI imaging: gastric volvulus: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: gastric volvulus

Sample item

An elderly woman has sudden severe epigastric pain with retching but no vomiting, and a nasogastric tube cannot be passed. A chest radiograph shows a retrocardiac gas bubble with an air-fluid level. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Acute gastric volvulus

Severe epigastric pain, unproductive retching and inability to pass a tube form the Borchardt triad of acute gastric volvulus, usually with a hiatus hernia. A retrocardiac gas-filled stomach with an air-fluid level supports it. It is a surgical emergency because of risk of ischaemia.

Option by option

  • A. Acute pancreatitis

    Pancreatitis causes pain radiating to the back and does not give a retrocardiac bubble.

  • B. Boerhaave syndrome

    Boerhaave rupture follows forceful vomiting and shows mediastinal air or effusion.

  • C. Acute gastric volvulus (correct)

    Correct. The triad with a retrocardiac gas-filled stomach points to gastric volvulus.

  • D. Achalasia cardia

    Achalasia causes slowly progressive dysphagia, not an acute abdomen.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Acute gastric volvulus. Severe epigastric pain, unproductive retching and inability to pass a tube form the Borchardt triad of acute gastric volvulus, usually with a hiatus hernia.

Why is "Acute pancreatitis" not the answer?

Pancreatitis causes pain radiating to the back and does not give a retrocardiac bubble.

Why is "Boerhaave syndrome" not the answer?

Boerhaave rupture follows forceful vomiting and shows mediastinal air or effusion.

Why is "Achalasia cardia" not the answer?

Achalasia causes slowly progressive dysphagia, not an acute abdomen.

What concept does this question test?

It tests Abdominal and GI imaging: gastric volvulus in Radiology. A retrocardiac gas-filled stomach with an air-fluid level supports it. It is a surgical emergency because of risk of ischaemia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: gastric volvulus?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.