Department of General Surgery, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.
Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kuching, Malaysia.
Asian J Endosc Surg. 2020 Jul;13(3):437-440. doi: 10.1111/ases.12740. Epub 2019 Jul 23.
Intrathoracic organo-axial gastric volvulus is a rare clinical entity associated with paraesophageal hernia. It is characterized by migration of the stomach into the thoracic cavity through an enlarged hiatal defect and rotation around its long axis connecting the cardia and the pylorus. A 72-year-old woman presented with epigastric pain that radiated to the left scapula for 1 week prior to presentation. Computed tomography scan of her thorax and abdomen demonstrated paraoesophageal hernia with organo-axial intrathoracic gastric volvulus. Laparoscopically, the stomach was returned to its abdominal position, the mediastinal sac was excised and after adequate intra-abdominal length of the esophagus was attained, the hiatal defect was closed primarily and reinforced with a composite mesh. An anterior 180° partial fundoplication was performed as both an anti-reflux procedure and also as a form of gastropexy. She had an uneventful recovery and remains well after 2 years.
胸腔内器官轴型胃旋转是一种罕见的临床病症，与食管裂孔疝有关。其特征为胃通过扩大的食管裂孔缺损进入胸腔，并围绕连接贲门和幽门的长轴旋转。一名 72 岁女性因左上腹痛放射至左肩胛骨就诊，疼痛症状在就诊前已持续 1 周。其胸部和腹部的计算机断层扫描显示食管裂孔疝伴胸腔内器官轴型胃旋转。腹腔镜下，胃被送回腹部，纵隔囊被切除，在获得足够的食管腹腔内长度后，食管裂孔被直接关闭，并使用复合网片加固。进行了前 180°部分胃底折叠术，既是抗反流手术，也是胃固定术。患者术后恢复顺利，2 年后情况良好。
