title: Acute intrathoracic gastric volvulus from a diaphragmatic hernia after left splenopancreatectomy: Report of a case.
abstract: Intrathoracic gastric volvulus is a rare event. It occurs when the stomach undergoes organoaxial torsion in the chest, caused either by concomitant enlargement of the hiatus or by a diaphragmatic hernia. A delay in diagnosis and treatment can result in fatal complications such as gastric ischemia, perforation, and hemorrhage. We report a case of intrathoracic localization of an acute and incarcerated organoaxial gastric volvulus caused by a left-sided diaphragmatic hernia resulting from a diaphragmatic injury. The patient had undergone a left splenopancreatectomy 4 years earlier for non-Hodgkin's lymphoma. We performed an emergency left thoracotomy with reduction of the acute volvulus, resection of the adhesions, and exeresis of an inflammatory mass from the omentum, with good results. The mechanisms of volvulus and diaphragmatic hernia with the relative diagnostic and therapeutic implications are discussed after this case report.
authors.affiliation: Department of Application in Surgery of Innovative Technologies, Section of General and Thoracic Surgery, University of Bari Medical School, Bari, 70124, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Testini
authors.forename: Angelo
authors.initials: A
authors.lastname: Vacca
authors.forename: Germana
authors.initials: G
authors.lastname: Lissidini
authors.forename: Beatrice
authors.initials: B
authors.lastname: Di Venere
authors.forename: Angela
authors.initials: A
authors.lastname: Gurrado
authors.forename: Michele
authors.initials: M
authors.lastname: Loizzi
mesh_terms: D016099:Endoscopy, Gastrointestinal; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D013156:Splenectomy / Q000009:adverse effects*; D013277:Stomach Volvulus / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed