A Case of Upside Down Stomach Type Esophageal Hiatal Hernia and Congenital Absence of Gallbladder Associated with Choledocholithiasis.

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  • Ｕｐｓｉｄｅ　ｄｏｗｎ　ｓｔｏｍａｃｈ型食道裂孔ヘルニアに総胆管結石合併胆嚢欠損症が併存した１例

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Abstract

A case of upside down stomach type esophageal hiatal hernia and congenital absence of gallbladder associated with choledocholithiasis is reported. A 76-year-old woman was admitted to the hospital with a diagnosis of cholelithiasis. A chest X-ray film showed air-fluid level in the mediastinum. An upper gastrointestinal series showed an upside down stomach with an esophageal hiatal hernia. No gallbladder was demonstrated by abdominal ultrasonography and computed tomography. Endoscopic retrograde cholangiography demonstrated stones in the common bile duct and obstruction of the cystic duct. With a diagnosis of upside down stomach, choledocholithiasis and severe atrophic gallbladder, the patient was operated on. The esophageal hiatal hernia in which the entire stomach prolapsed, the dilated common bile duct and stones in the duct were found. But the gallbladder and cystic duct were absent. Resection of the hernia sac, reduction suture of the esophageal hiatus, fixation of the fundus of the stomach to the diaphragm, choledocholithotomy and choledochoduodenostomy were performed. No postoperative complications occurred. The patient was discharged from the hospital on the 18th postoperative day.

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