A Case of a Type III Esophageal Hiatal Hernia with an Upside Down Stomach Successfully Treated by Laparoscopic Mesh Repair

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  • MASUDA Hiroki
    Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
  • MATSUTANI Takeshi
    Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
  • NOMURA Tsutomu
    Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
  • HAGIWARA Nobutoshi
    Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
  • UCHIDA Eiji
    Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School

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Other Title
  • 腹腔鏡下修復術を行ったupside down stomachを伴う食道裂孔ヘルニアの1例
  • 症例 腹腔鏡下修復術を行ったupside down stomachを伴う食道裂孔ヘルニアの1例
  • ショウレイ フククウキョウ カ シュウフクジュツ オ オコナッタ upside down stomach オ トモナウ ショクドウレツコウ ヘルニア ノ 1レイ

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Abstract

An 86-year-old woman was admitted to the hospital because of vomiting and epigastric discomfort after meal for last several years. Chest x-ray examination revealed abnormal gas image in the left thoracic cavity. Esophagogastroduodenoscopy disclosed serious deformity of the stomach that disturbed the endoscope to reach to the pyloric side from the middle portion of the gastric body. Upper gastrointestinal radiographic series and a chest CT scan demonstrated herniation of most of the stomach into the lower mediastinum. Type III esophageal hiatal hernia with an upside down stomach was diagnosed. Laparoscopic surgery was performed. The herniated stomach was reduced into the abdomen. The hiatal hernia defect was closed by primary suture and was reinforced by mesh placement. Fundoplication was then performed with the Toupet method. The postoperative course was uneventful. The patient had developed neither relapse nor further symptoms for a 6-month follow-up after the operation. We report a rare case of a type III esophageal hiatal hernia with an upside down stomach which was successfully treated by laparoscopic surgery.

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