A Case of Gastric Cancer with Esophageal Hiatal Hernia Complicated by an Upside-down Stomach Successfully Treated by Laparoscopic Surgery

Abstract

We experienced a rare case of gastric cancer with esophageal hiatal hernia complicated by an upside- down stomach successfully treated by laparoscopic surgery. The patient was a 73-year-old woman who was referred to our hospital with a diagnosis of early gastric cancer. Upper gastrointestinal series showed an upside-down stomach, which was prolapsed into the diaphragm. Gastrointestinal endoscopy revealed 0-IIc type tumor on the greater curvature of the antrum. She was diagnosed with an early gastric cancer with esophageal hiatal hernia. Considering the kyphosis, delayed recovery due to wound pain, and visual field in the mediastinum, laparoscopic distal gastrectomy with D1+ dissection and esophageal hiatal hernia repair were performed simultaneously. She had a good postoperative course and was discharged at the 11^th postoperative day.