Gastric volvulus (GV) is an uncommon pathology that results from a twist of the stomach of more than 180 degrees around its own axis, causing a closed-loop obstruction [1,2]. GV represents a potentially life-threatening surgical emergency [3-5]. Computed tomography (CT) is the gold standard test for its diagnosis, as the clinical symptoms are nonspecific [6,7]. Recently, the term ‘back-and-forth stomach’ has been proposed for some authors to describe a type of GV with specific radiological features. According to these authors, this pathophysiological mechanism is highly prevalent, and may account for the majority of cases reported to date [1,8]. In line with this theory, a sliding hiatal hernia (HH) first occurs, progressively enlarging until it includes a large portion or the entire stomach in the mediastinum. Subsequently, the stomach rotates horizontally, which predisposes the fundus to reherniate back into the abdominal cavity through the esophageal hiatus, generating a GV and triggering acute obstruction due to the inability to drain the gastric contents.

The main objective of this study is to describe and analyze the radiological characteristics of GV and to contribute to the knowledge regarding the ‘back-and-forth stomach’ theory. As a secondary objective, the aim is to identify factors associated with the presence of radiological complications.