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LAPAROSCOPIC DIAPHRAGMATIC PLICATION AND FUNDOPEXY FOR THE TREATMENT OF LEFT DIAPHRAGMATIC PARALYSIS AND INTRA-ABDOMINAL GASTRIC VOLVULUS
Jared McDonald
2, Robert Anderton
*2, Farzaneh Banki
11Cardiothoracic and Vascular Surgery, University of Texas Health Science Center, Memorial Hermann Southeast Esophageal Disease Center, Houston, TX; 2The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, TX
Introduction: 65 Y F presents with SOB on exertion and recurrent episodes of epigastric pain radiating to the left shoulder, tachycardia, and hypertension.
Method: She was found to have a paralyzed left hemidiaphragm and intra-abdominal gastric volvulus.
Results: She underwent laparoscopic left diaphragmatic plication and fundopexy and was discharged on POD 2. At 13 months follow-up, she has mild SOB and is free of preoperative attack episodes.
Conclusion: Left diaphragmatic paralysis can result in intra-abdominal gastric volvulus. Laparoscopy is an alternative to thoracotomy that allows diaphragmatic plication and treatment of gastric volvulus in the same setting and with good outcomes.
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