Mide Volvulusu ile Birlikte Mikst Hiatal Herni: Nadir Görülen Bir Akut Karın Tablosu

Abstract

Introduction: Gastric volvulus occurs when the stomach rotates more than 180 degrees, and it is a rare surgical condition. It is a potentially life-threatening entity, and most cases of gastric volvulus occur in association with a hiatal hernia. Gastric volvulus is a rare condition and presents with nonspecific abdominal symptoms. Hence, endoscopy and computed tomography can help the diagnosis. Emergent surgical approach is mandatory.   Case Report: We present in this article a 73-year-old woman who had acute abdominal symptoms. Endoscopic and radiological imaging revealed gastric volvulus with a mixed hiatal hernia and choledocholithiasis. The patient underwent emergent surgery, and she was discharged healthy.   Conclusion: Borchardt’s triad during a hiatal hernia makes the physician consider acute gastric volvulus. The diagnosis should be corrected with endoscopic and radiological imaging. Proper surgical treatment methods should be applied. Other abdominal pathologies, such as choledocholithiasis, may accompany this condition, and they should also be kept in mind.

Keywords

• Gastric volvulus, hiatal hernia, choledocholithiasis

Gastric Volvulus with Mixed Hiatal Hernia: A Rare Picture of Acute Abdomen

Abstract

Introduction: Gastric volvulus occurs when the stomach rotates more than 180 degrees, and it is a rare surgical condition. It is a potentially life-threatening entity, and most cases of gastric volvulus occur in association with a hiatal hernia. Gastric volvulus is a rare condition and presents with nonspecific abdominal symptoms. Hence, endoscopy and computed tomography can help the diagnosis. Emergent surgical approach is mandatory. Case Report: We present in this article a 73-year-old woman who had acute abdominal symptoms. Endoscopic and radiological imaging revealed gastric volvulus with a mixed hiatal hernia and choledocholithiasis. The patient underwent emergent surgery, and she was discharged healthy. Conclusion: Borchardt’s triad during a hiatal hernia makes the physician consider acute gastric volvulus. The diagnosis should be corrected with endoscopic and radiological imaging. Proper surgical treatment methods should be applied. Other abdominal pathologies, such as choledocholithiasis, may accompany this condition, and they should also be kept in mind

Keywords

• Gastric volvulus, hiatal hernia, choledocholithiasis

References

1. Chau B, Dufel S. Gastric volvulus. Emerg Med J 2007; 24: 446-7. [CrossRef]
2. Ellis H. (çev: Andican A.): Divertikül, volvulus ve ileus. In Schwartz SI, Ellis H., ed(s) (çev. editörü: Andican A.). Maingot Abdominal Operasyonlar. 8. baskı. İstanbul: Nobel Tıp Kitabevi; 1989. s. 531-48.
3. Chiue CC, Wang W, Wei PL, Lee WJ. Giant diaphragmatic hernia intrathoracic gastric volvulus. Endoscopy 2006; 38: 52-3. [CrossRef]
4. Lee TC, Liu KL, Lin MT, Wang HP. Unusual cause of emesis in an octogenarian: organoaxial gastric volvulus associated with paraesophageal diaphragmatic hernia. J Am Geriatr Soc 2006; 54: 555-7. [CrossRef]
5. Wasselle JA, Norman J. Acute gastric volvulus: Pathogenesis, diagnosis, and treatment. Am J Gastroenterol 1993; 88: 1780-4.
6. Germanos S, Gourgiotis S, Saedon M, Lapatsanis D, Salemis NS. Severe abdominal pain as a result of acute gastric volvulus. Int J Emerg Med 2010; 3: 61-2. [CrossRef]
7. Bawahab M, Mitchell P, Church N, Debru E. Management of acute paraesophageal hernia. Surg Endosc 2009; 23: 255-9. [CrossRef]
8. Schiano di Visconte M, Barbaresco S, Burelli P, Da Ros D, Di Bella R, Lombardo C, et al. Acute abdomen due to a strangulated and perforated para-esophageal hernia. A case report. Chir Ital 2002; 54:563-7.

9. Koontz CS, Wulkan M. Lesions of the stomach. In Holcomb GW, Murphy JP (eds). Ashcraft’s Pediatric Surgery. 5th ed. Philadelphia: Saunders Elsevier; 2010. p. 391-9. [CrossRef]