2020 Volume 45 Issue 4 Pages 338-344
Gastric volvulus is a rare disease, but is sometimes recurrent. Therefore, it should be treated by surgery. We report the case of an adult patient with gastric volvulus and hiatal hernia who was treated by laparoscopic surgery. An 84-year-old woman with a history of vomiting was referred to our hospital. She gave a history of having been diagnosed as having gastric volvulus thrice in the previous 6 months. Abdominal computed tomography showed mesentero-axial gastric volvulus with a hiatal hernia. We performed esophagogastroduodenoscopy, which revealed no areas of necrosis. Therefore, we retained a stomach tube, released the hernia, and discharged the patient. Three days later, however, the patient returned with recurrent gastric volvulus, and we performed laparoscopic surgery. First, we performed reefing of the esophageal hiatus and reconstructed the cardia by the Toupet method. Then, we performed gastropexy between the greater curvature and the left diaphragm. The postoperative course was uneventful. Until now, 7 months after the surgery, there has been no recurrence. Laparoscopic gastropexy for gastric volvulus is considered to be a minimally invasive and safe method, even if there is hiatal hernia.
