TWO CASES OF CHRONIC GASTRIC VOLUVLUS ASSOCIATED WITH EVENTRATION OF THE DIAPHRAGM

Abstract

Gastric voluvlus was formerly a rare disease. With the spread of contrast radiography of the upper digestive tract, however, the number of cases of this disease has increased. We recently encountered two cases of chronic gastric voluvlus associated with eventration of the diaphragm. Case 1 was a 51-year-old man whose chief complaint was left hypochondralgia. He was diagnosed as gastric voluvlus associated with eventration of the diaphragm by chest X-ray films and contrast radiography of the upper digestive tract. The case was complicated with perforation resulting from gastric ulcer. The stomach was resected by operation, and multi-layer diaphragmoplasty was preformed. The patient is doing well. Case 2 was a 61-year-old woman whose chief complaint was a burning sensation in the epigastric region. The case was diagnosed as gastric voluvlus by roentgenographic and endoscopic examinations. Symptoms disappeared with the administration of conservative therapy. At present, the clinical course is under observation, with attention being paid to the possible development of complications. Gastric voluvulus is rather easily diagnosed if its existence is kept in mind. For acute cases, surgery is indicated. Even for chronic cases, surgery is indicated where symptoms are severe and complications or incarceration are also observed. In selecting surgical techniques, thorough studies should be made with consideration given to the age and presence or absence of complications.