A Case of Laparoscopic Surgery for Esophageal Hiatal Hernia Complicated by an Upside Down Stomach

Patient 1 was a 76-year-old woman with chief complaints of reflux symptoms and anorexia. She had esophageal hiatal hernia associated with stomach cancer. Endoscopic submucosal dissection was considered difficult; thus, distal gastrectomy and esophageal hiatal plication were performed. Patient 2 was a 78-year-old woman with chief complaints of nausea and vomiting. Prolapse of the gastric corpus into the mediastinum was observed. Thus, surgery was performed for passage obstruction treatment. Because reflux symptoms were not observed, cardioplasty was not performed; however, esophageal hiatal plication was performed. Patient 3 was a 68-year-old woman with the chief complaint of continuous vomiting. Passage obstruction was observed. She had a history of reflux esophagitis. Cardioplasty and esophageal hiatal plication using a mesh were performed. All these three cases involved gastric volvulus, with most part of the whole stomach being impacted into the thoracic cavity, and showed a relatively rare upsidedown stomach. Here we report the surgical procedures performed for these esophageal hiatal hernia cases with a review of the literature.

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Three Cases with Esophageal Hiatal Helnia Shownig Upside Down Stomach

Kobayashi

Iwanami

Sato

et al. 2019

kmj

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Upside Down Stomach with Gastric Volvulus in a Mesenteroaxial Form Successfully Treated by Laparoscopic Surgery: A Case Report

Matsumoto

Omura

Mouri

et al. 2017

JJCS

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A 67-year-old woman had experienced intermittent vomiting. She was admitted to our hospital because the symptom did not improve. An upper gastrointestinal barium study, computed tomography and gastrointestinal endoscopy showed esophageal hiatal hernia through which a large part of the gastric body herniated into the mediastinum. Therefore, we diagnosed upside down stomach with gastric volvulus in a mesenteroaxial form. Attempts at endoscopic repair failed to reduce the stomach, and laparoscopic surgery was performed. The enlarged esophageal hiatus was sutured with a mesh reinforcement, and Toupet fundoplication was performed as an antireflux procedure. The postoperative course was uneventful, and the patient was discharged on the postoperative day 14. Recently we sometimes encounter cases of upside down stomach in the literature, but this disease is rare and only 41 cases have been reported in Japan. We herein report such a case successfully treated by laparoscopic surgery.

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非還納性upside down stomachを呈した進行胃癌の１例

Yahiro,

Shimamura,

Kamiya

et al. 2022

JJCS

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Municipal General HospitalAn 83-year-old woman was referred to our hospital with the chief complaints of anorexia and nausea.Upper gastrointestinal endoscopy revealed advanced gastric cancer of the gastric body. Abdominal CT revealed an upside-down stomach (UDS). The tumor short diameter was greater than the diameter of the esophageal hiatal hernial orifice, suggesting that the tumor was incarcerated. We diagnosed the patient as having esophageal hiatal hernia with incarcerated UDS with advanced gastric cancer, and performed distal gastrectomy and esophageal hiatus suture. Although gastric cancer with an UDS is rare, there is a possibility of incarcerated hernia in cases of advanced gastric cancer. Therefore, it is necessary to select the surgical approach and method for each case taking into account the relationship between the UDS and gastric cancer.

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A Case of Laparoscopic Surgery for Esophageal Hiatal Hernia Complicated by an Upside Down Stomach

Cited by 3 publications

References 11 publications

Three Cases with Esophageal Hiatal Helnia Shownig Upside Down Stomach

Three Cases with Esophageal Hiatal Helnia Shownig Upside Down Stomach

Upside Down Stomach with Gastric Volvulus in a Mesenteroaxial Form Successfully Treated by Laparoscopic Surgery: A Case Report

非還納性upside down stomachを呈した進行胃癌の１例

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