Abstract
An 83-year-old woman was admitted to our hospital because of epigastralgia and nausea. A computed tomography examination showed that the stomach, with mesenteroaxial gastric volvulus, was located in the mediastinum. She was diagnosed as having an upside-down stomach and esophageal hiatal hernia. After conservative therapy, she underwent laparoscopic cruroplasty and Toupet fundoplication. The mesh was placed around the esophagus and secured to the diaphragm and crura for reinforcement. The patientʼs postoperative course was favorable, and she was discharged on postoperative day 10. Three months after surgery, she showed no signs of relapse. The laparoscopic surgery was useful for the treatment of esophageal hiatal hernia accompanied by upside-down stomach, but in future, surgical procedure and mesh hiatoplasty with more safety and lower recurrence rate is required.
