TY - JOUR
T1 - Cardiopulmonary impairments caused by a large hiatal hernia with organoaxial gastric volvulus showing upside-down stomach
T2 - A case report
AU - Umemura, Akira
AU - Suto, Takayuki
AU - Fujiwara, Hisataka
AU - Ikeda, Kenichiro
AU - Nakamura, Seika
AU - Hayano, Megumi
AU - Nitta, Hiroyuki
AU - Takahara, Takeshi
AU - Hasegawa, Yasushi
AU - Katagiri, Hirokatsu
AU - Kanno, Shoji
AU - Sasak, Akira
N1 - Publisher Copyright:
© Am J Case Rep, 2019.
PY - 2019
Y1 - 2019
N2 - Objective: Rare co-existance of disease or pathology Background: Upside-down stomach (UDS) is the rarest type of hiatal hernia (HH), with organoaxial gastric volvulus. A large HH sometimes causes cardiopulmonary impairments owing to multiple factors. Case Report: We herein report a case of a large HH with UDS that had induced weight loss and severe cardiopulmonary dysfunction in a 74-year-old female patient who presented with shortness of breath, chest pain, severe anorexia, and weight loss of 5 kg over the 3 previous months. Chest X-ray and CT examination revealed that her heart was retracted on the right side, and the hernia contents had induced physical compression of the left lung on the cranial side. Spirometry revealed that the patient’s vital capacity (VC), percentage VC, and percentage forced expiratory volume (% FEV) at 1 s were 1.32 L, 60.2%, and 67.5%, respectively. A barium swallow test confirmed a diagnosis of HH with UDS. On the basis of these findings, we performed a laparoscopic Nissen procedure, which resulted in the patient’s dramatic recovery. Postoperative examinations showed that the stomach and heart were once again normally located, and the left lung had re-inflated. Postoperative spirometry dramatically improved. Conclusions: A large HH causes cardiac and pulmonary compression due to mass effects and leads to cardiopulmonary dysfunction. For cases that have both a complicated HH and cardiopulmonary dysfunction owing to the mass effects of hernia contents, laparoscopic HH repair can be a good alternative procedure.
AB - Objective: Rare co-existance of disease or pathology Background: Upside-down stomach (UDS) is the rarest type of hiatal hernia (HH), with organoaxial gastric volvulus. A large HH sometimes causes cardiopulmonary impairments owing to multiple factors. Case Report: We herein report a case of a large HH with UDS that had induced weight loss and severe cardiopulmonary dysfunction in a 74-year-old female patient who presented with shortness of breath, chest pain, severe anorexia, and weight loss of 5 kg over the 3 previous months. Chest X-ray and CT examination revealed that her heart was retracted on the right side, and the hernia contents had induced physical compression of the left lung on the cranial side. Spirometry revealed that the patient’s vital capacity (VC), percentage VC, and percentage forced expiratory volume (% FEV) at 1 s were 1.32 L, 60.2%, and 67.5%, respectively. A barium swallow test confirmed a diagnosis of HH with UDS. On the basis of these findings, we performed a laparoscopic Nissen procedure, which resulted in the patient’s dramatic recovery. Postoperative examinations showed that the stomach and heart were once again normally located, and the left lung had re-inflated. Postoperative spirometry dramatically improved. Conclusions: A large HH causes cardiac and pulmonary compression due to mass effects and leads to cardiopulmonary dysfunction. For cases that have both a complicated HH and cardiopulmonary dysfunction owing to the mass effects of hernia contents, laparoscopic HH repair can be a good alternative procedure.
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U2 - 10.12659/AJCR.918191
DO - 10.12659/AJCR.918191
M3 - Article
C2 - 31624225
AN - SCOPUS:85073508121
SN - 1941-5923
VL - 20
SP - 1530
EP - 1535
JO - American Journal of Case Reports
JF - American Journal of Case Reports
ER -