A case of acute gastric volvulus associated with eventration of the diaphragm in a previously well 6 year old child is reported. The child presented with acute abdominal pain, abdominal distension and vomiting. At operation, mesentero-axial type gastric volvulus was found, associated with laxity of the gastro-splenic, gastrohepatic and gastrocolic ligaments and eventration of the left hemidiaphragm. Rapid recovery followed surgery that included release of distension and fixation of the stomach to the anterior abdominal wall. There has been no evidence of recurrence on a 2 year follow-up.
Paraesophageal hernia with intrathoracic mesentericoaxial type of gastric volvulus is a rare clinical entity. The rotation occurs because of the idiopathic relaxation of the gastric ligaments and ascent of the stomach adjacent to the oesophagus through the hiatus defect, while the gastroesophageal junction remains in the abdomen. The open approach remains the gold standard therapy for most patients. Here we report the case of a patient with such a condition who underwent a successful laparoscopic surgery. A literature search revealed that this is the first case report from Southeast Asia.