A Case of Advanced Gastric Cancer within Sliding Hiatal Hernia Assosiated with Organoaxial Gastric Volvulus

Tatsuyuki Seshimo, Masao Ito, Kazunobu Monden and Tomoo Mizukami

Department of Surgery, Unitika Central Hospital

A 78-year-old woman was admitted to our hospital because of upper abdominal symptoms including nausea and anorexia. A chest X-ray film showed an air-fluid level in the mediastinum. An upper gastrointestinal series demonstrated a sliding hiatal hernia with gastric volvulus in an organoaxial form and a filling defect of the antrum. The patient was diagnosed as having Borrmann 2 carcinoma of the antrum by the endoscopic examination. A laparotomy revealed that the entire stomach was dislocated toward the mediastinum. Subsequent distal gastrectomy and repair of the esophageal hiatus were performed. Herein we report the first case of advanced gastric cancer within a sliding hiatal hernia associated with organoaxial gastric volvulus in Japan.

Key words
sliding hiatal hernia, organoaxial volvulus, advanced gastric cancer

Reprint requests
Tatsuyuki Seshimo Department of Surgery, Unitika Central Hospital 24-1 Uji-Umonji, Uji, 611-0021 JAPAN

Accepted
March 31, 1999

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