J Gastric Cancer.  2015 Jun;15(2):147-150. 10.5230/jgc.2015.15.2.147.

Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

• Lee HY
• Park JH
• Kim SG

• KMID: 2372364
• DOI: http://doi.org/10.5230/jgc.2015.15.2.147

Abstract

Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

Keyword

Stomach volvulus; Laparoscopy; Gastropexy; Endoscopy

MeSH Terms

Aged
Barium
Emergency Service, Hospital
Endoscopy
Esophagogastric Junction
Female
Gastropexy*
Humans
Laparoscopy
Meals
Nausea
Pyloric Antrum
Stomach
Stomach Volvulus*
Barium

Figure

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  Fig. 1 (A) A simple abdominal radiograph showing a double bubble sign in the left upper abdomen. (B) A markedly distended stomach with transposition of the gastroesophageal junction and gastric antrum.

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  Fig. 2 (A) An upper gastrointestinal study revealed the presence of mesenteroaxial gastric volvulus with the finding that the antrum was located above the gastroesophageal junction (red arrow). (B) Gastroscopic finding: abnormal rotation of the axis can be seen. EG = esophagogastric.

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  Fig. 3 (A) Photos showing the placement of 4 trocars. Four 3-mm incisions were made for the anterior gastropexy. (B) Gastropexy with prolene sutures. The sutures were lifted through the 3-mm skin incisions.

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  Fig. 4 A postoperative upper gastrointestinal study confirmed complete reduction of the gastric volvulus.

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