Ann Short Rep | Volume 1, Issue 4 | Case Report | Open Access
Damiano Chiari1*, Paolo Veronesi1, Marco Platto1, Giacomo Borroni2 and Walter Zuliani1
1Department of General Surgery, Humanitas University, Italy
2Department of General Surgery, University of Insubria, Italy
*Correspondance to: Damiano Chiari
Fulltext PDFIntroduction: Few cases of intrathoracic gastric volvulus associated with para-oesophageal hernia have been reported and most of these cases were treated with open approach. We present a case of a giant type IV para-oesophageal hernia composed of part of the transverse colon and part of the stomach with volvulus. The patient was a 66-years-old male. He performed the following diagnostic tests: gastroscopy, barium swallow and CT scan. The patient was candidate surgical treatment with laparoscopic approach at our Centre. Technique: The patient was submitted to laparoscopic repair of the paraesophageal hernia. Reducing the transverse colon and the stomach in the abdomen, the gastric volvulus resolved. A primary cruroplasty with interrupted sutures was performed. A Nissen fundoplication was performed in order to recreate the anti-reflux valve.
Results: The post-operative course was uneventful. The patient started drinking and eating on first and second post-operative day respectively. The discharge occurred three days after surgery. A month after surgery, an oesophagography showed a rapid bolus transit from the oesophagus to the stomach and the patient was asymptomatic for reflux symptoms or dysphagia. One year after surgery, the gastroscopy was regular and the patient he continued to feed normally, increasing his body weight. Conclusions: Repair of type IV para-oesophageal hernia with intra-thoracic gastric volvulus can be performed safely and successfully with laparoscopic approach by expert surgeons.
Chiari D, Veronesi P, Platto M, Borroni G, Zuliani W. Laparoscopic Treatment of a Giant Type IV Hiatal Hernia with Intrathoracic Gastric Volvulus: A Case Report. Ann Short Reports. 2018;1:1018.