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Query: UMLS:C0042961 (volvulus)
4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The laparoscopic management of the intrathoracic stomach is still controversial. Laparoscopic semifundoplication in gastroesophageal reflux disease results in effective long-term reflux control and is, as compared with 360 degrees Nissen fundoplication, associated with less frequent side effects such as dysphagia and gas bloat syndrome. The aim of our study was to evaluate the results of laparoscopic anterior semifundoplication in patients with intrathoracic stomach. Enrolled in this study are 19 patients (67.1 years of age; range, 37.5-83.7 years) with intrathoracic stomach undergoing laparoscopic anterior semifundoplication and a minimal follow up of 5 months postoperatively. The study covers the interval between August 1999 and March 2006. Including criterion was a minimum percentage of herniated intrathoracic stomach of 33 per cent. A standardized questionnaire was used for follow up and the modified symptomatic DeMeester score (0-9) was assessed. The median percentage of herniated stomach in the chest was 87.5 per cent (range, 33-100%). Seven patients revealed organo-axial volvulus of the stomach. Duration of preoperative symptoms was 24 months (range, 1-266 months) with a median follow up of 18 months (range, 5-76 months) postoperatively. The modified symptomatic DeMeester score was 0 (0-3). Thirteen of 19 patients were on no postoperative proton pump inhibitor medication. One patient had anatomic recurrence on late follow up at 27 months. The overall contentment with the surgical treatment on an analog scale from 0 to 10 was a median of 9. Although laparoscopic anterior semifundoplication yields satisfactory symptomatic results in patients with intrathoracic stomach, the incidence of failures and anatomical recurrences is higher than expected from subjective data. Prospective, randomized long-term studies are essential to gain further information about the "ideal" type of laparoscopic repair in large hiatal hernia with intrathoracic stomach.
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PMID:Laparoscopic anterior semifundoplication in patients with intrathoracic stomach. 1827 22

An 86-year-old woman was admitted to the hospital to undergo an examination for tarry stools. Laboratory tests showed hypoproteinemia and renal dysfunction. Upper gastrointestinal endoscopy demonstrated a type 5 tumor located in the upper body of the stomach. An upper gastrointestinal series and computed tomography revealed an organoaxial gastric volvulus and the dislocation of the proximal stomach through an esophageal hiatal hernia. The preoperative diagnosis was the incarceration of a gastric carcinoma arising from the proximal stomach with an organoaxial gastric volvulus through an esophageal hiatal hernia. A total gastrectomy and hernia repair were performed. A microscopic examination of the surgical specimen revealed a gastric large cell neuroendocrine carcinoma (GLCNEC). The patient was discharged 22 days after the surgery. Although the prognosis of GLCNEC is significantly worse than that of a conventional adenocarcinoma, the patient was doing well without recurrence at 15 months after surgery. The details of this case are reported with some bibliographical comments.
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PMID:Incarceration of a large cell neuroendocrine carcinoma arising from the proximal stomach with an organoaxial gastric volvulus through an esophageal hiatal hernia: report of a case. 1919 95

Congenital paraesophageal hiatal hernias are rare and can be associated with gastric incarceration, volvulus,mucosal ulceration, and anemia. Primary repair of the hernia and fundoplication are recommended. In this paper,we report a case of a 3-year-old child with abdominal pain who was noted to have a paraesophageal hiatal hernia with partial gastric volvulus. A 5 mm robot platform was utilized to facilitate hernia sac dissection,hiatal repair, and fundoplication.
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PMID:Robotic repair of congenital paraesophageal hiatal hernia. 1933 24

The hiatus hernia and sigmoid volvulus are usually found in older patients. The delay of the treatment of both of these illnesses may result in increased morbidity and mortality. We report a case of an isolated intrathoracic hiatal herniation of the twisted sigmoid colon. The patient complained about cramping abdominal pain, vomiting, and dyspnea. Chest X-ray and CT scan of the thorax showed a distended colonic segment in the posterior mediastinum. The patient underwent cruroplasty, Nissen fundoplication, and sigmoid colon resection. This is the first report of such a rare case.
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PMID:Isolated intrathoracic hiatal herniation of the twisted sigmoid colon: report of a case. 1940 83

Gastric volvulus is a potentially lethal condition. We report a case of esophageal hiatal hernia with strangulation of the esophagus and stomach caused by gastric volvulus. A 79-year-old woman was admitted to our hospital in a state of shock, and investigations showed necrotic changes in most of her distal esophagus and gastric body. Thus, we performed an emergency total gastrectomy and transhiatal esophagectomy, followed 3 months later by successful reconstruction of the esophagus using the jejunum. Occasionally, a large hiatal hernia accompanies gastric volvulus; however, the extent of esophageal necrosis observed in this patient is very unusual. Although a large hiatal hernia is usually a chronic disorder, surgical treatment is recommended, considering the risk of serious complications.
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PMID:Successful treatment of acute esophageal necrosis caused by intrathoracic gastric volvulus: report of a case. 1999 3

Intrathoracic gastric volvulus associated with neonatal paraesophageal hernia is very rare in the newborn period. We report a case of a 3-week-old term infant who presented to the hospital with a history of non-bilious vomiting. Workup for hypertrophic pyloric stenosis eventually revealed the presence of a congenital hiatal hernia and intrathoracic gastric volvulus requiring urgent surgical management. The infant underwent successful laparoscopic repair. We discuss the diagnosis and management of this extremely rare surgical cause of neonatal nonbilious emesis.
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PMID:Laparoscopic management of neonatal paraesophageal hernia with intrathoracic gastric volvulus. 2071 99

Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal hernia, volvulus, and gastroesophageal reflux.
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PMID:Laparoscopic repair of hiatal hernia with mesenterioaxial volvulus of the stomach. 2152 87

Acute intrathoracic gastric volvulus occurs when the stomach undergoes organoaxial torsion in the chest due to either concomitant enlargement of the hiatus or a diaphragmatic hernia. Iatrogenic diaphragmatic hernia can occur after hiatal hernia repair and other surgical procedures, such as nephrectomy, esophagogastrectomy and splenopancreatectomy. We describe a 49-year-old woman who presented to our emergency department with acute moderate epigastric soreness and vomiting. She had undergone extensive gynecologic surgery including splenectomy 1 year before. The chest radiograph obtained in the emergency department demonstrated an elevated gastric air-fluid level in the left lower lung field. An urgent gastroscopy showed twisted structural abnormality of the stomach body. A computed tomography scan demonstrated the distended stomach, located in the left lower hemithorax through a left diaphragmatic defect. Emergent transthoracic repair was performed. Postoperative recovery was uneventful, and the patient did not experience any pain or difficulty with eating.
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PMID:Acute Intrathoracic Gastric Volvulus due to Diaphragmatic Hernia: A Rare Emergency Easily Overlooked. 2188 28

An 80-year-old male patient with a history of a hiatus hernia presented with acute abdominal pain and vomiting. CT of his abdomen revealed extraluminal free gas consistent with a perforation. He had a large hiatus hernia. The subdiaphragmatic portion of the stomach was distended and adopted a more transverse lie. The radiological findings were in keeping with acute gastric volvulus with secondary ischaemic complications. Acute gastric volvulus is an abnormal rotation of the stomach resulting in complete obstruction. It is a surgical emergency and does not always present in its classical form. Clinicians should be mindful of this diagnosis in patients presenting with an acute surgical abdomen, especially if the presentation is non-specific, as delays in diagnosis are associated with significant morbidity and mortality.
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PMID:Acute gastric volvulus: an uncommon complication of a hiatus hernia. 2267 18

An 89-year-old woman with a known hiatus hernia presented to the accident and emergency department with acute onset epigastric pain. CT of the thorax and abdomen revealed a large hiatus hernia with mesentero-axial volvulus but no evidence of strangulation. A large aneurysmal aortic arch and descending aorta were visible with associated mural thrombus. As the pain was worsening, following discussion with the patient, the decision to operate was taken. The hiatus hernia was successfully reduced and the stomach looked healthy. The oesophagus, however, appeared black almost throughout its entire length consistent with acute oesophageal necrosis syndrome, a rare and lethal disease. Left lateral thoracotomy followed by cervicotomy was performed to retrieve a healthy oesophageal segment, which was anastomosed to the cardiac end of the stomach. Despite treatment in the intensive care unit, the patient's condition progressively deteriorated and she died of multiorgan failure 12 days later.
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PMID:Acute oesophageal necrosis syndrome. 2271 55


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