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This article discusses a rare case of retroperitoneal paraganglioma, a type of tumor that affects the retroperitoneum, which is the area behind the abdominal cavity. The patient, a 55-year-old male, presented with intense abdominal pain and high blood pressure. Diagnostic tests, including ultrasound, computed tomography (CT), and 18-F-DOPA PET-CT scans, confirmed the presence of the tumor. The patient underwent surgery and had a favorable outcome. The article emphasizes the importance of recognizing the diverse manifestations of retroperitoneal paragangliomas for accurate diagnosis and treatment. [Extracted from the article]

We have carefully read the interesting article recently published in your journal about a giant sigmoid diverticulum. In our institution we have diagnosed two similar cases and we would like to contribute our casuistry.

Background: Gastric volvulus (GV) is a life-threatening emergency condition that prompts emergent surgical management. With the advent of high-resolution computed tomography (CT), the role of radiologists in its diagnosis has become essential. Although many cases of GV have been described in the literature, its pathophysiology is still poorly understood. In addition, there is substantial terminological confusion with associated entities such as paraesophageal hernia, upside-down stomach, organo-axial or chronic GV., Methods: We conducted a retrospective review of clinical, radiological findings and other relevant data for seven patients with previous radiological diagnoses of a large hiatus hernia who presented with acute GV to the emergency department of our institution. We report data on age, sex, medical history, clinical presentation, imaging, treatment and outcomes for each case., Results: The CT findings at acute presentation showed the antrum lying above the diaphragm and dilated fundus below the diaphragm. By comparing the position of the stomach at acute presentation with previous imaging examinations, we confirmed a hypothesis put forward by a few authors decades ago that re-herniation of the gastric fundus into the abdomen is a common pathophysiologic trigger leading to acute GV. This hypothesis has not been supported by modern imaging examinations., Conclusions: We have provided imaging evidence supporting that the pathophysiology of many GVs is based on caudal re-descent of hiatal hernia into the abdominal cavity. Given the terminological disparity used in the literature in this context, we believe it appropriate to introduce and extend the term 'back-and-forth stomach' to refer to this type of GV.