Gastric Volvulus and Splenic Hematoma in a Paraoesophageal Hernia

Abstract

A 70 year old gentleman presented with features of gastric outlet obstruction. He had recently been investigated for upper GI symptoms and a barium meal had revealed a large paraoesophageal hernia. He had positive gastric splash. Endoscopy confirmed the presence of a hiatus hernia with associated gastric volvulus. He underwent exploratory laparotomy and was found to have a large paraoesophageal hernial sac containing most of the stomach, part of the omentum and the spleen. There was organoaxial volvulus of the stomach and a large subcapsular splenic haematoma. Splenectomy with repair of the hernia and gastropexy was performed after reducing the contents and excising the sac. He recovered well and was discharged on the eleventh postoperative day