A case of gastric cancer resection in a patient with an esophageal hiatal hernia and an upside down stomach

Abstract

An extremely rare case of a patient who underwent radical resection for gastric cancer complicated by an upside down stomach, with prolapse of the entire stomach and stomach volvulus associated with an esophageal hiatal hernia, is reported. The patient was a 73-year-old woman who was referred and admitted to our department with a diagnosis of advanced gastric cancer after visiting another physician complaining of pressure in the upper abdomen. Upper gastrointestinal series revealed an upside down stomach, with the entire stomach prolapsed into the diaphragm. Upper gastrointestinal endoscopy showed type 3 gastric cancer in the pyloric antrum. Based on these findings, the patient was diagnosed with an esophageal hiatal hernia and advanced gastric cancer. Open total gastrectomy, D2 dissection, and esophageal hiatal hernia repair were performed. The final diagnosis was type 5, T2(MP), N1, H0, P0, M0, stage II, with a curability of A. No postoperative complications were observed, and the patient was discharged on day 12. She currently has no complaints or evidence of relapse, and she is being followed on an outpatient basis. The relevant literature is also reviewed.