Abstract
Gastric volvulus, defined as an abnormal rotation of the stomach, is a rare disease that is often caused by diaphragmatic defects and poor fixation of the stomach. This report describes a case of gastric volvulus associated with paraesophageal hiatal hernia, which relapsed after conservative treatment. An 80-year-old man was admitted to the hospital because of vomiting just after eating. Computed tomography of the chest and abdomen showed incarceration of the gastric antrum within the mediastinum. The patient was diagnosed with mesenteroaxial volvulus of the stomach associated with paraesophageal hiatal hernia. Because of the lack of strangulation, conservative treatment was provided and elective surgery was planned. However, the torsion reduced spontaneously and the patient was discharged without surgery. As vomiting reappeared 9 days after discharge, he was again admitted. Relapse of gastric volvulus was diagnosed from computed tomography of the chest and abdomen and surgery was performed. Laparotomy revealed incarceration of the antrum, so we reduced the volvulus and repaired the hernia orifice. He has experienced no relapse of the volvulus or hiatal hernia. Since there was a possibility of relapse in this case, we considered surgical treatment as necessary even if the gastric volvulus had again reduced spontaneously.
