RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187821117
T1 Paraesophageal Hernia, Laparoscopic and Robotic
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187821117
RD 2023/03/31
AB Hiatal  hernias  are  classified  as  types  I–IV,  with  types  II–IV  representing  forms  of  paraesophageal  hernia  (PEH)  (FIGURE  1).  Patients  with  PEH  may  develop  gastric  volvulus,  which  is  classified  based  on  the  axis  of  rotation  (FIGURE  2).  Organoaxial  volvulus  is  the  most  common  type,  and  it  accounts  for  almost  all  cases  of  acute  gastric  volvulus  (FIGURE  2A).  This  involves  rotation  of  the  stomach  around  the  anatomic  (longitudinal)  axis,  represented  as  a  line  drawn  from  the  cardia  to  the  pylorus,  frequently  resulting  in  gastric  strangulation.  In  mesoentericoaxial  volvulus,  the  antrum  of  the  stomach  rotates  anteriorly  and  superiorly  around  a  transverse  axis  that  extends  from  the  middle  of  the  lesser  curvature  to  the  middle  of  the  greater  curvature  (FIGURE  2B).  The  rotation  is  typically  incomplete  and  results  in  intermittent  gastric  obstruction  rather  than  acute  strangulation.