臓器軸性胃軸捻転症を伴った成人食道裂孔ヘルニアの1例

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  • A CASE OF ADULT HIATAL HERNIA ASSOSIATED WITH ORGANOAXIAL GASTRIC VOLVULUS

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A 51-year-old woman was admitted to the hospital because of epigastric discomfort and pain after meals. A chest X-ray film showed a gastric air bubble in the posterior mediastinum and an upper gastrointestinal series showed a sliding hiatal hernia with organoaxial gastric volvulus. Magnetic resonance imaging scan also revealed that the entire stomach, transverse colon and greater omentum were incarcerated into the left pleural cavity. Laparotomy was carried out, and the prolapsed organs were easily reduced into the abdominal cavity. The esophageal hiatus was enlarged to about 6×4.5cm in diameter. Repair of the esophageal hiatus and Nissen fundoplication were performed successfully. Esophageal hiatal hernia is common in infants and children, but uncommon in adults. This case of hiatal hernia in an adult is thought to be rare in that the entire stomach prolapsed and was associated with organoaxial gastric volvulus.

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