A Case of Parahiatal Hernia with Gastric Volvulus Repaired by Laparoscopic Surgery

Abstract

The patient was an 84-year-old woman who consulted an emergency outpatient unit with anorexia and vomiting. Chest X-ray and thoracoabdominal computed tomography (CT) suggested an esophageal hiatal hernia. Reduction by upper gastrointestinal endoscopy was performed. After discharge, recurrence of the symptoms was noted, and detailed examination led to a diagnosis of parahiatal hernia. Surgical treatment was selected, with laparoscopic closure of the esophageal hiatus and hernial orifice, mesh placement, and fundoplication with the Toupet method. During the 1-year postoperative follow-up, there has been no recurrence. A parahiatal hernia is rare, and an appropriate operative procedure has not been determined. However, it may be important to prevent recurrence and postoperative gastroesophageal reflux disease. The case of a patient in whom endoscopic reduction of a parahiatal hernia was performed, followed by elective laparoscopic surgery, was described.