A Case of Early Gastric Carcinoma Associated with an Organoaxial Stomach Volvulus Through Paraesophageal Hiatal Hernia - A Case Report and Review of Literature

Apoorva P, Arun B, Nutan D, Saloni C and Varjang B

Fortis Hospital Mulund, Maharashtra, India

^*Correspondance to: Apoorva Pawar 

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Abstract:

Paraesophageal Hernia (PEH) is the herniation of the intra-abdominal organs into the thoracic space via the esophageal hiatus. An upside-down stomach is when there is herniation of the stomach along with organoaxial volvulus and is a rare entity.
We present a case of an elderly patient diagnosed with early gastric cancer arising in an upside-down stomach. An elderly man presented with complaints of bloating sensation, belching and anorexia since the past 3 to 4 months. An esophagogastroduodenoscopy was done which revealed a large hiatus hernia with gastric volvulus, chronic atrophic gastritis, and a superficial lesion on anterior stomach wall. Lesion was suggestive of early gastric cancer, which was confirmed on biopsy as a well-differentiated adenocarcinoma. After imaging, the patient underwent reduction of the gastric volvulus and hiatal repair followed by distal gastrectomy and gastropexy of residual stomach with Billroth II reconstruction.
On table esophagogastroscopy was done to delineate the extend of the gastric lesion and ensure complete excision of the lesion as it had minimal thickening.
To our knowledge, out of the 18 cases reported prior to this of malignancy in upside down stomach, this is the 5th case to have an early gastric carcinoma.

Keywords:

Upside-down stomach; Gastric volvulus; Gastric carcinoma

Cite the Article:

Apoorva P, Arun B, Nutan D, Saloni C, Varjang B. A Case of Early Gastric Carcinoma Associated with an Organoaxial Stomach Volvulus Through Paraesophageal Hiatal Hernia - A Case Report and Review of Literature. World J Surg Surgical Res. 2023; 6: 1492..