2023 Volume 65 Issue 6 Pages 1110-1116
The case subject was an 83-year-old woman. On upper gastrointestinal endoscopy examination performed for close examination of heartburn symptoms and feeling of chest tightness, early-stage gastric cancer presenting a 0-Ⅱa lesion of 10 mm in size in the angular incisure of the lesser curvature was observed. Endoscopic treatment was indicated; however, manipulation of the scope was difficult due to the presence of a type Ⅳ esophageal hiatal hernia with upside down stomach. Due to the subjectʼs advanced age, and to minimize the degree of invasiveness, upon deliberation with the department of surgery, surgical repair of the esophageal hiatal hernia was performed, after which the early-stage gastric cancer could be treated by performing ESD. We report a possible treatment method for early-stage gastric cancer concurrent with type Ⅳ esophageal hiatal hernia presenting with an upside down stomach in an elderly individual with a review of the literature.
