Patient presents with symptoms suggestive of gastric volvulus, including acute abdominal pain, nausea, vomiting, retching without emesis, and epigastric distension.  The patient may describe a feeling of fullness and inability to belch or vomit.  Onset of symptoms may be acute or chronic.  Depending on the type of volvulus, organoaxial or mesenteroaxial, the patient may exhibit varying degrees of respiratory distress.  Physical examination may reveal abdominal tenderness, tympany, and absent bowel sounds.  Differential diagnosis includes acute gastric dilatation, small bowel obstruction, and myocardial infarction.  Imaging studies, such as an upper gastrointestinal series or CT scan of the abdomen and pelvis, are crucial for confirming the diagnosis of gastric volvulus and determining the axis of rotation.  Treatment plan may include emergent endoscopic decompression or surgical intervention, such as gastropexy, to prevent recurrence.  Preoperative assessment will include evaluation of cardiovascular and respiratory status.  Postoperative care will focus on pain management, fluid and electrolyte balance, and monitoring for complications such as perforation or ischemia.  ICD-10 code K31.82, Gastric volvulus, is used for billing and coding purposes.  CPT codes for procedures performed, such as esophagogastroduodenoscopy or laparoscopic gastropexy, will be documented accordingly.  Patient education regarding dietary modifications and follow-up care will be provided.