Hernia hiatal mixta con vólvulo gástrico intratorácico: Reporte de caso y revisión de la literatura

Introduction: A volvulated intrathoracic stomach (IVD) is a hiatal hernia type characterized by the presence of a large portion of the stomach ascended into the mediastinum. It is considered to be a pathology of great importance because of the high probability of mortality associated when not diagnosed and operated promptly. Case report: A 56-year-old female patient presents with acute epigastric pain associated with nausea and multiple emetic episodes of food content. She did not have any relevant medical or surgical history. Endoscopy of the upper digestive tract and a chest x-ray were performed and reported a possible gastric volvulus and a widening of the lower mediastinum associates to the presence of the gastric chamber inside the thoracic cavity. Discussion: Because of the high risk of complications, the diagnosis of an intrathoracic gastric volvulus indicates emergency surgery. In clinically stable patients with an acute presentation of gastric obstruction, laparoscopic approach is suggested for its reduction and hernia repair. However, in cases of unstable patients, open surgery should be considered the method of choice.