Successful treatment of acute esophageal necrosis caused by intrathoracic gastric volvulus: report of a case.
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.
Matsumoto
Noritaka
N
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Oki
Eiji
E
Morita
Masaru
M
Kakeji
Yoshihiro
Y
Egashira
Akinori
A
Sadanaga
Noriaki
N
Maehara
Yoshihiko
Y
D000368:Aged; D016638:Critical Illness; D004638:Emergency Treatment; D016629:Esophagectomy / Q000379:methods; D004947:Esophagus / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006551:Hernia, Hiatal / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D009336:Necrosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D013277:Stomach Volvulus / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome