Case Report
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2011; 17(15): 2054-2057
Published online Apr 21, 2011. doi: 10.3748/wjg.v17.i15.2054
Laparoscopic repair of hiatal hernia with mesenterioaxial volvulus of the stomach
Kazuki Inaba, Yoichi Sakurai, Jun Isogaki, Yoshiyuki Komori, Ichiro Uyama
Kazuki Inaba, Yoichi Sakurai, Jun Isogaki, Yoshiyuki Komori, Ichiro Uyama, Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutsukake-cho Toyoake, Aichi 470-1192, Japan
Author contributions: Inaba K drafted the manuscript; Isogaki J, Komori Y and Uyama I gathered the data; Sakurai Y comprehensively reviewed and edited the manuscript.
Supported by The Department of Surgery Fujita Health University School of Medicine and University Hospital
Correspondence to: Yoichi Sakurai, MD, PhD, FACS, Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutsukake-cho Toyoake, Aichi 470-1192, Japan. ysakurai@fujita-hu.ac.jp
Telephone: +81-562-939254 Fax: +81-562-939011
Received: August 9, 2010
Revised: September 27, 2010
Accepted: October 4, 2010
Published online: April 21, 2011
Abstract

Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal hernia, volvulus, and gastroesophageal reflux.

Keywords: Gastric volvulus; Mesenterioaxial form; Hiatal hernia; Mesh repair; Laparoscopic procedure