Case reports in gastroenterology · 2014
Gastric Cancer Arising from an Upside-Down Stomach through a Paraesophageal Hiatal Hernia.
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Mimatsu Kenji, Kano Hisao, Oida Takatsugu, Kawasaki Atsushi, Fukino Nobutada, Kida Kazutoshi, Kuboi Youichi, Amano Sadao
Аннотация
We report the rare case of an elderly patient with an advanced gastric cancer arising from an upside-down stomach through a paraesophageal hiatal hernia (PEH). An 82-year-old man presented with appetite loss and anemia. Upper gastrointestinal endoscopy revealed a type 1 tumor located in the middle body of the stomach. An upper gastrointestinal series and computed tomography showed organoaxial rotation of the stomach, which was located in the mediastinum, through a PEH, indicating an upside-down stomach. The preoperative diagnosis was gastric cancer arising from an upside-down stomach through a PEH. The patient underwent total gastrectomy with lymph node dissection and closure of the hernial orifice. Although a large PEH is a chronic disorder, gastric malignancies should be considered in patients with PEH manifested as an upside-down stomach due to its anatomical characteristics, and careful preoperative diagnosis is mandatory.