Laparoscopic repair of complete intrathoracic stomach with iron deficiency anemia: A case report

Figure 1 Preoperative chest X-ray. An intrathoracic gastric bubble with increased bilateral lung marking.

Figure 2 Chest computed tomography with volumetric analysis. Post-mediastinal location of the whole stomach along with peritoneal fat compressing both bilateral lung and heart.

Figure 3 Barium contrast radiography. Confirming large hiatal hernia, and the configuration of the stomach within the hernia suggested an organoaxial volvulus.

Figure 4 Esophageal high-resolution manometry. The presence of hiatal hernia with an elevated level of lower esophageal sphincter of 9.6 cm high, pathological acid reflux.

Figure 5 Mesh reinforcement and Nissen fundoplication. A: The homemade liver retractor. External view of reverse “7” shaped, homemade liver retractor; B: Intra-operative view of the retractor; C: Repositioning of intra-abdominal esophagus. Three centimeters of tension-free esophagus was repositioned intra-abdominally; D: Three hundred sixty degree Nissen fundoplication and mesh reinforcement.

Figure 6 Postoperative chest x-ray at 1-mo follow up. There were no distinct abnormalities observed.