A case of esophageal hiatal hernia complicated by a gastric volvulus

Abstract

We describe a case with an esophageal hiatal hernia complicated by a gastric volvulus and review the relevant literature. A 59-year-old woman developed epigastric pain and vomiting. CT scans and an upper gastrointestinal series showed that the stomach was rotated in a mesenterioaxial fashion, and that the antrum of the stomach was incarcerated into the lower mediastinum. The patient was diagnosed as having an esophageal hiatal hernia complicated by a gastric volvulus. The attempted endoscopic reduction of the volvulus was unsuccessful. Therefore, a laparotomy was carried out. Adhesions were observed between the esophageal hiatus and the rotated lower body of the stomach. Following reduction of the hernia, the esophageal hiatus was repaired and a gastropexy was performed. Fundoplication was not performed, because the patient had no symptoms of gastroesophageal reflux. The multiplanar CT reformation technique provided detailed anatomical information and was useful for diagnosing the gastric volvulus.