Three Cases with Esophageal Hiatal Helnia Shownig Upside Down Stomach

Abstract

Patient 1 was a 76-year-old woman with chief complaints of reflux symptoms and anorexia. She had esophageal hiatal hernia associated with stomach cancer. Endoscopic submucosal dissection was considered difficult; thus, distal gastrectomy and esophageal hiatal plication were performed. Patient 2 was a 78-year-old woman with chief complaints of nausea and vomiting. Prolapse of the gastric corpus into the mediastinum was observed. Thus, surgery was performed for passage obstruction treatment. Because reflux symptoms were not observed, cardioplasty was not performed; however, esophageal hiatal plication was performed. Patient 3 was a 68-year-old woman with the chief complaint of continuous vomiting. Passage obstruction was observed. She had a history of reflux esophagitis. Cardioplasty and esophageal hiatal plication using a mesh were performed. All these three cases involved gastric volvulus, with most part of the whole stomach being impacted into the thoracic cavity, and showed a relatively rare upsidedown stomach. Here we report the surgical procedures performed for these esophageal hiatal hernia cases with a review of the literature.