부산대학교 도서관

We report an adult case of idiopathic gastric volvulus successfully treated by laparoscopic gastropexy. A 24-year-old woman with mental retardation referred to our hospital because of abdominal pain, vomiting and abdominal distention. Abdominal computed tomography revealed mesentero-axial volvulus of the stomach. The endoscopic detorsion was attempted, but it resulted in failure. However, by the decompression with a nasogastric tube, we succeeded in detorsion two days later. In the case with the mental disease it is considered that the recurrence rate is relatively high, because of aerophagia and chronic dilatation of stomach or colon1）. Her parents hoped the preventive operation worrying about the future of the daughter. Then we performed laparoscopic gastropexy. Operation was done with 3 ports, and gastropexy was made with three lines running sutures. Postoperative course was uneventful. 1 year after surgery, there has been no recurrence. The recurrence rate of idiopatic gastric volvulus is fairly high. Therefore the preventive operation should be considered as one of the treatment options, especially in the case with mental disease. The fixation method by some lines running sutures may be the useful procedure, because it is possible to fix the wide range of the stomach to the abdominal wall.