Good History and High Suspicion of Gastric Volvulus in Patient With Known Hiatal Hernia Are Key to Better Outcomes

Abstract A 43 years old female with laparoscopic sleeve gastrectomy (SG) and an ‘anterior’ hiatal hernia repair 11 years ago, presented with 3 years history dysphagia and heartburn. Upper gastrointestinal barium showed an almost complete intrathoracic migration of the SG with a partial organoaxial volvulus. Upper endoscopy revealed a 10 cm hiatal hernia with grade B esophagitis. Laparoscopic revision surgery with reduction of the gastric sleeve, standard posterior hiatal hernia repair, resection of the narrowed remnant of the SG and conversion to a gastric bypass was performed. No postoperative complications occurred. The patient is asymptomatic at 2 years of follow-up. We present the technical standards for the management and discuss the suspected pathophysiology of this rare but challenging condition.

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Acute Gastric Volvulus on Hiatal Hernia

Case Reports in Surgery ◽

10.1155/2020/4141729 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Abdessamad EL KAOUKABI ◽

Mohamed MENFAA ◽

Samir HASBI ◽

Fouad SAKIT ◽

Abdelkrim CHOHO

Keyword(s):

Hiatal Hernia ◽

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

Gastric Volvulus ◽

Upper Gastrointestinal Endoscopy ◽

Rare Entity ◽

Midline Laparotomy ◽

Acute Gastric Volvulus ◽

Upper Abdominal ◽

Upper Gastrointestinal

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

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Congenital paraesophageal hiatal hernia with intrathoracic gastric volvulus in an infant: a case report with radiographic sequence

Pediatric Surgery International ◽

10.1007/s00383-007-1955-1 ◽

2007 ◽

Vol 24 (4) ◽

pp. 467-470 ◽

Cited By ~ 7

Author(s):

Jiledar Rawat ◽

Kumar A. Rashid ◽

Shandip Kumar Sinha ◽

Sarita Singh ◽

Dhiraj Parihar

Keyword(s):

Case Report ◽

Hiatal Hernia ◽

Gastric Volvulus ◽

Paraesophageal Hiatal Hernia

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Hydropneumomediastinum Secondary to Gastric Volvulus Perforation in a Patient With Giant Hiatal Hernia

Archivos de Bronconeumología (English Edition) ◽

10.1016/j.arbr.2014.03.005 ◽

2014 ◽

Vol 50 (4) ◽

pp. 154

Author(s):

Francisco Javier Garcipérez de Vargas ◽

Sergio Luis Moyano Calvente ◽

Gonzalo Marcos

Keyword(s):

Hiatal Hernia ◽

Gastric Volvulus ◽

Giant Hiatal Hernia

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Gastric volvulus after laparoscopic Nissen fundoplication and hiatal closure performed due to giant hiatal hernia: A case report

10.5348/z12-2015-4-cr-4 ◽

2020 ◽

Keyword(s):

Case Report ◽

Hiatal Hernia ◽

Nissen Fundoplication ◽

Gastric Volvulus ◽

Laparoscopic Nissen Fundoplication ◽

Hiatal Closure ◽

Giant Hiatal Hernia ◽

Laparoscopic Nissen

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A CASE OF ESOPHAGEAL HIATAL HERNIA COMPLICATED BY A GASTRIC VOLVULUS

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.70.3550 ◽

2009 ◽

Vol 70 (12) ◽

pp. 3550-3555 ◽

Cited By ~ 1

Author(s):

Shuji MORITA ◽

Rie YASUOKA ◽

Yoshinobu SONOYAMA ◽

Hiroshi FUJIKI ◽

Manabu MITSUO ◽

...

Keyword(s):

Hiatal Hernia ◽

Gastric Volvulus ◽

Esophageal Hiatal Hernia

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Organoaxial Gastric Volvulus Caused by Incarceration of a Gastric Stromal Tumor in Paraesophageal Hiatal Hernia

The American Surgeon ◽

10.1177/000313481307900912 ◽

2013 ◽

Vol 79 (9) ◽

pp. 312-313

Author(s):

Chia-Hung Su ◽

Li-Chun Chen ◽

Jan-Sing Hsieh ◽

Jui-Ying Lee

Keyword(s):

Hiatal Hernia ◽

Gastric Volvulus ◽

Stromal Tumor ◽

Gastric Stromal Tumor ◽

Paraesophageal Hiatal Hernia

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Black oesophagus, upside-down stomach and cameron lesions: cascade effects of a large hiatal hernia

BMJ Case Reports ◽

10.1136/bcr-2021-246496 ◽

2021 ◽

Vol 14 (11) ◽

pp. e246496

Author(s):

Smit Sunil Deliwala ◽

Murtaza S Hussain ◽

Anoosha Ponnapalli ◽

Ghassan Bachuwa ◽

Grigoriy E Gurvits

Keyword(s):

Hiatal Hernia ◽

Gastric Volvulus ◽

Outlet Obstruction ◽

Low Flow ◽

Compensatory Mechanisms ◽

Acute Exacerbations ◽

Paraesophageal Hiatal Hernia ◽

Black Oesophagus ◽

Cascade Effects ◽

Cameron Lesions

Acute oesophageal necrosis, black oesophagus (BE) or Gurvits syndrome (GS) is a rare form of severe oesophagitis appearing as a striking circumferential discolouration of distal mucosa with various proximal extensions abruptly terminating at the gastro-oesophageal junction. It is most commonly associated with acute exacerbations of medical comorbidities, while associations with altered gut anatomy are rare. We present a unique constellation of BE, Cameron ulcers (CU), and gastric volvulus from a large paraesophageal hiatal hernia. Our patient recently recovered from COVID-19 and was malnourished and frail, while the expanding paraesophageal hiatal hernia turned into an acute organoaxial gastric volvulus with accompanying outlet obstruction. In low-flow post-COVID coagulopathic states, compensatory mechanisms may lack against gastric stunning and sudden massive reflux on the oesophagus. We additionally performed a systematic review and discovered additional cases with coexistent volvulus and paraesophageal hernia, although there are no previous reports of BE with CU, which makes this study the first.

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