Chronic Mesenteroaxial Gastric Volvulus and Congenital Diaphragmatic Hernia: Successful Laparoscopic Repair

Gastric volvulus is a rare cause of recurrent abdominal pain in children. Usually it is associated with diaphragmatic pathology. A 9-year-old boy presented with recurrent abdominal pain and vomiting. Investigations confirmed a volved stomach in the left chest and a left congenital diaphragmatic hernia (CDH). Laparoscopic reduction and repair of CDH was performed successfully. The stomach was devolved and reduced into the abdomen. No gastropexy was performed. The patient is asymptomatic 2 years after surgery. Traditional treatment of gastric volvulus has been derotation and gastropexy with the anterior abdominal wall. Our case shows that gastropexy may not be needed in all cases. Also, this is perhaps the first case to undergo laparoscopic repair of CDH and gastric volvulus in pediatric population.