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Upside-down stomach in paraesophageal hernia: A case report
Xiuliang Zhu1, Chengyu Hu2, Weihua Gong3
1Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Medicine
|December 22, 2023
Summary
Giant paraesophageal hernias with gastric inversion are rare but serious. Prompt surgical repair is crucial for successful outcomes in these uncommon cases.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Thoracic Surgery
Background:
- Paraesophageal hernias (PEH) are a subset of hiatal hernias, accounting for 5-10% of cases.
- Gastric inversion is a rare but severe complication of giant PEH.
- This case highlights the diagnostic and therapeutic challenges associated with this condition.
Observation:
- A 60-year-old male presented with acute epigastric pain, distension, and vomiting.
- Imaging revealed a diaphragmatic defect with herniation of the stomach, spleen, and colon into the left hemithorax.
- Diagnosis was confirmed as giant paraesophageal hernia with complete gastric inversion.
Findings:
- Surgical repair involved closing a 10x8 cm diaphragmatic defect and repositioning herniated abdominal contents.
- The herniated contents included the stomach, spleen, colon, pancreas, and omentum.
- The patient had an uncomplicated recovery and was discharged 12 days post-surgery.
Implications:
- Gastric inversion in giant PEH is exceptionally rare and can be misdiagnosed due to non-specific symptoms.
- Timely surgical intervention, guided by comprehensive imaging, is essential for managing this condition.
- This case provides valuable clinical insights into the successful management of inverted gastric PEH.
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