A Case of Giant Esophageal Hiatal Hernia Showing an Upside Down Stomach

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  • Upside down stomachを呈した巨大食道裂孔ヘルニアの1例

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Abstract

A 79-year-old woman was urgently admitted to our hospital with complaints of frequent nausea and vomiting. Based on the computer tomography findings, she was diagnosed as having a giant esophageal hiatal hernia showing an upside down stomach. Gastrofiberscopy revealed grade D gastro-esophageal reflux disease (GERD). She underwent a surgical procedure composed of a hiatal hernia repair and Nissen fundoplication after conservative treatment. The esophageal hiatus was wide measuring 4 by 3 cm and it was repaired using a mesh. Moreover, the gastric fundus was sutured with the diaphragm to fix the stomach. The postoperative course was favorable, and the patient was discharged on post-operative day 15. She remains in good condition without recurrence 6 months after surgery. Although an esophageal hiatal hernia showing an upside down stomach is rare, early diagnosis and accurate surgery with a lower recurrence rate is required because a severe condition might occur in acute cases.

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