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Gastric Cancer Arising from an Upside-Down Stomach through a Paraesophageal Hiatal Hernia.

Authors
  • Mimatsu, Kenji
  • Kano, Hisao
  • Oida, Takatsugu
  • Kawasaki, Atsushi
  • Fukino, Nobutada
  • Kida, Kazutoshi
  • Kuboi, Youichi
  • Amano, Sadao
Type
Published Article
Journal
Case Reports in Gastroenterology
Publisher
S. Karger AG
Publication Date
Jan 01, 2014
Volume
8
Issue
1
Pages
107–114
Identifiers
DOI: 10.1159/000361012
PMID: 24761138
Source
Medline
Keywords
License
Unknown

Abstract

We report the rare case of an elderly patient with an advanced gastric cancer arising from an upside-down stomach through a paraesophageal hiatal hernia (PEH). An 82-year-old man presented with appetite loss and anemia. Upper gastrointestinal endoscopy revealed a type 1 tumor located in the middle body of the stomach. An upper gastrointestinal series and computed tomography showed organoaxial rotation of the stomach, which was located in the mediastinum, through a PEH, indicating an upside-down stomach. The preoperative diagnosis was gastric cancer arising from an upside-down stomach through a PEH. The patient underwent total gastrectomy with lymph node dissection and closure of the hernial orifice. Although a large PEH is a chronic disorder, gastric malignancies should be considered in patients with PEH manifested as an upside-down stomach due to its anatomical characteristics, and careful preoperative diagnosis is mandatory.

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