A case of 100-year-old woman successfully treated for upside down stomach with laparoscopic surgery

Abstract

We report a case of a 100-year-old woman successfully treated for upside down stomach with laparoscopic surgery. She was admitted to our hospital because of hematemesis accompanied with acute respiratory and renal failure. Chest X-ray showed the effusion in the whole left pleural cavity and atelecta-sis in the left lung lobe. Abdominal computed tomography revealed the entire gastric incarceration into the left pleural cavity with esophageal hiatal hernia and with gastric volvulus. She was diagnosed as upside down stomach caused by combined esophageal hiatal hernia with organoaxial gastric volvulus, and underwent laparoscopic surgery because her general condition was so stable that she could stand the operation. After the incarcerated stomach and greater omentum were easily reduced into her abdominal cavity, the hiatus could be directly closed, and then Toupet fundoplication was performed to prevent reflux esophagitis. Postoperative course was uneventful, and she was discharged on the 13th day after the operation. © 2011 The Japanese Society of Gastroenterological Surgery.