Colonic displacement: Proposed treatment for gastric remnant volvulus due to eventration of the diaphragm

Abstract

Displacement of the gastric remnant in patients with left diaphragmatic eventration may lead to gastric remnant volvulus requiring surgical correction. This results from the strong negative intrathoracic pulling force created by the potential subphrenic space and paradoxical movement of the diaphragm. Unless this strong negative force is first eliminated, gastropexy alone is likely to result in recurrence. Obliteration of the subphrenic space by colonic displacement is an effective and simple way of abolishing this negative subdiaphragmatic pulling force. Once this is achieved, any form of gastropexy will suffice to permanently prevent gastric remnant translocation and volvulus.