Laparoscopic management of chronic gastric volvulus: A case report

Abstract

Gastric volvulus (GV) is a rare pathological entity, which is difficult to diagnose, may rapidly progress to infarction and necrosis of the stomach, and can be fatal. A 68-year-old woman presented to the surgical outpatient clinic of Istanbul University, Istanbul Faculty of Medicine, in August, 2006, with a 3-month history of nausea, vomiting, and recurrent abdominal pain. Physical examination revealed epigastric tenderness, but otherwise within normal limits. An urgent abdominal computed tomographic examination revealed only a paraesophageal hernia. A mesenteroaxial gastric volvulus with a large paraesophageal hernia was found on laparoscopy. The surgical procedure involved derotation of the stomach and closure of the paraesophageal hernia with a dual V-shaped graft gastropexy to the triangular ligament of liver; in addition, a laparoscopic cholecystectomy was performed. We found that derotation of stomach and gastropexy to the triangular ligament is technically easy to perform and is a safe procedure in the treatment of gastric volvulus.