Enunciado A male patient, 52 years old, was referred to the Alfa Institute of Gastroenterology with chronic pain in the left upper abdomen for about 10 years, associated with bloating, early satiety and postprandial fullness. The patient reported diminished appetite and weight loss of approximately 20 kilograms during this period. On physical examination, the patient was slimmed, and the palpation presented a painful upper abdomen. An upper endoscopy suggested alteration of gastric morphology without alterations in the mucosa. The following imaging tests were done. Image 1: Postero-anterior chest radiograph.Image 2: Computed tomography of the abdomen with oral and intravenous contrasts.Image 3: Contrasted radiography, supine, right posterior oblique incidence.Image 4: Contrasted radiography, supine, left posterior oblique incidence. Question:Based on the clinical picture and the images which one of the following is the most likely diagnosis and definitive therapy? Organoaxial gastric volvulus / nasogastric catheterization Gastric cancer / surgical resection Chronic mesenteroaxial gastric volvulus / gastrostomy with anterior gastropexy Functional dyspepsia / proton pump inhibitors and dietary guidelines Time is Up! Time's up
