Abstract
Vast majority of hiatal hernias of the esophagus are sliding type, and other types are rarely encountered. This paper presents an extremely rare case of hiatal hernia of the esophagus with prolapsed gastric vestibule associating with gastric volvulus.
An 81-year-old woman was seen at the hospital because of shortness of breath on excercise. She had evacuated tarry stool. Anemia was noted. Upper gastrointestinal series revealed a paraesophageal type hiatal hernia in which a portion from the body to vestibule of the stomach was axially twisted by 180 degree to prolapse, and an associated sliding hernia. A possible risk of acute strangulation was considered and the patient was operated on by Nissen procedure. Intraoperative findings included that gastric volvulus and paraesophageal hernia were repositioned and only the sliding hernia still existed. It was inferred that the repositioning might be attributed to general anesthesia. Postoperative course was uneventful. Any recurrence of hernia has not been found.
