title: Hiatal hernia with upside-down stomach. Management of acute incarceration: case presentation and review of literature.
abstract: Upside-down stomach (UDS) represents the rarest type of hiatal hernia (<5%) and is characterized by herniation of the entire stomach or most gastric portions into the posterior mediastinum. We present here a very rare complication of such a condition which is incarceration of upside-down stomach. A 54 year-old female was admitted to the emergency department presenting signs of acute epigastric pain radiating into thorax. Computed tomography revealed a giant hiatal hernia with incarceration of the gastric trunk. Immediate operation for reduction of the incarcerated stomach and repair of the hiatal defect was performed. The patient was discharged without any complication and was followed up at the surgical outpatient department. The presented case confirms that differentiation of an acute epigastric or intrathoracic pain in adults should always exclude presence of hiatal hernia which in case of incarceration should be treated by prompt surgical management.
authors.affiliation: Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, Kraków, Poland. msgrygle@cyf-kr.edu.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Gryglewski
authors.forename: Marcin
authors.initials: M
authors.lastname: Kuta
authors.forename: Artur
authors.initials: A
authors.lastname: Pasternak
authors.forename: Zdzisław
authors.initials: Z
authors.lastname: Opach
authors.forename: Jerzy
authors.initials: J
authors.lastname: Walocha
authors.forename: Piotr
authors.initials: P
authors.lastname: Richter
mesh_terms: D034841:Abdominal Cavity / Q000000981:diagnostic imaging; D000208:Acute Disease; D005260:Female; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D013277:Stomach Volvulus / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Hiatal hernia; Nissen procedure; fundoplasty; incarceration; upside-down stomach