Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutsukake-cho Toyoake, Aichi 470-1192, Japan.
World J Gastroenterol. 2011 Apr 21;17(15):2054-7. doi: 10.3748/wjg.v17.i15.2054.
Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal hernia, volvulus, and gastroesophageal reflux.
尽管系膜轴胃旋转是一种不常见的疾病，其特征是胃在横轴上旋转，但腹腔镜修复手术仍存在争议。我们报告了一例系膜轴胸腔内胃旋转，成功地使用聚四氟乙烯网和 Toupet 胃底折叠术治疗膈疝裂孔缺陷的腹腔镜修复。一位 70 岁的日本女性因突发上腹痛而被收入我院。上消化道造影显示远端胃和十二指肠的胸腔内肠系膜轴旋转性嵌顿。完全采用腹腔镜方法治疗扭转。腹腔镜手术包括使用聚四氟乙烯网和 Toupet 胃底折叠术修复疝裂孔。该病例突出了腹腔镜手术的可行性和有效性，使用聚四氟乙烯网和 Toupet 胃底折叠术修复膈疝裂孔可能有助于预防疝裂孔、扭转和胃食管反流术后复发。
