Abstract
This paper presents a case of massive hiatal hernia with gastric volvulus. A 71-year-old woman, who had suffered from persistent cough for several years, was admitted to the hospital because of severe cough and dyspnea attack. Chest roentogenogram showed a gastric air bubble with fluid level in the posterior mediastinum. Upper gastrointestinal examination showed that the distal corpus and antrum of the stomach migrated into the posterior mediastinum and greater curvature side ultimately occupied the highest position to form “upside down stomach”. There was no displacement of esophagogastric junction and no findings of obstruction of the lumen despite of the torsion of the stomach. The patient was diagnosed as organoaxial volvulus of the stomach associated with large paraesophageal hiatal hernia. In view of the avoidance of the recurrent attacks, the abdomen was opened. The stomach was withdrawn, the hernial orifice was repaired, and the fundus of the stomach was fixed to the peritoneal wall for the prevention of recurrecne. As of two years after the operation she is enjoying symptom free daily life.
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