Presentation
Dyspnea, especially postprandial, and dysphagia.
Patient Data
The stomach is completely herniated through the diaphragmatic hiatus into the thorax and is rotated along its long axis. Proximal part of duodenum (D1), a segment of transverse colon, and abdominal fat have also herniated into the thorax. There are no signs of acute obstruction.
Case Discussion
Hiatal hernia represents displacement of the gastric fundus into the thorax. There are four types (I-IV). In this case (type IV), there is complete displacement of the stomach into the thorax (along with other organs).
Gastric volvulus is a twisting of the stomach on its mesentery and can be organo-axial or mesentero-axial. In organo-axial volvulus, the stomach is rotated along its long axis and this type of volvulus is associated with intra-thoracic herniation.