A case of gastric cancer associated with esophageal hiatus hernia presenting horizontal torsion of the stomach

Abstract

A 74years old female visited our hospital suffering from low-grade fever and myalgia. She was diagnosed as polymyalgia rheumatica and given medical treatment of predonin. Laboratory data during the treatment showed anemia, then several examination of upper gastrointestinal tract was performed. Upper gastrointestinal X-ray photo showed the upside down stomach with large tumor on the lesser curvature of the stomach associated with esophageal hiatus hernia. Gastroscopic findings revealed Borrmann 3 type gastric cancer located from middle body to antrum of the stomach. The result of the biopsy was group V , moderately differentiated tubular adenocarcinoma. Surgical treatment of distal gastrectomy and radical operation for esophageal hiatus hernia was performed. Pathological examination showed stage III A, se, INFβ, ly₂, v₁, n₁. After the operation, 8 month passed. So far, gastroscopic and abdominal CT examination showed no evidence of local recurrence and of distant metastasis.
Esophageal hiatus hernia is frequently observed disease, but a case of gastric cancer associated with esophageal hiatus hernia presenting horizontal torsion of the stomach is rare case. We reported here about this case, taking into consideration with some references.