PMC6854275_01
Barrium upper GI. Half the stomach body in right position.
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An abdominal CT-scan with IV injection confirmed the diagnosis of incomplete gastric volvulus associated with the PEH (Fig. 1).
Anterior gastropexy with running unresorbable V-loc 2.0.
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Due to the patient's advanced age and comorbidities, we performed a posterior cruroplasty without mesh reinforcement, associated to an anterior gastropexy with continuous running suture with barbed non-resorbable 2/0, anchoring 3/4th of the stomach to the anterolateral abdominal muscles (Fig. 2).
PMC6854275_02
Abdominal CT. Complete intramediastinal volvulus.
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A thoraco-abdominal CT-scan showed a giant paraesophageal hernia with complete intramediastinal gastric volvulus (Fig. 3).
Cruroplasty reinforced with ePTFE pledgets.
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After complete gastric reduction and sac excision we performed a posterior cruroplasty reinforced with two ePTFE large strips (Fig. 4).