case_images: PMC11136698_01
case_images: Computed tomography findings on initial admission (a-c) Computed tomography shows hiatal hernia and incarceration of a part of the gastric body into the abdominal cavity. The red arrows show the incarceration of a part of the gastric body into the abdominal cavity, and the yellow arrows show the compressed duodenum.
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case_images: PMC11136698_01_DEO2-5-e377-g003.jpg
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case_images: Computed tomography revealed a hiatal hernia and incarceration of a part of the gastric body into the abdominal cavity (Figures 1a-c).
case_images: Fluoroscopic and esophagogastroduodenoscopic findings on initial admission (a) This fluoroscopic image shows the incarceration of a part of the gastric body into the abdominal cavity. The red arrow shows the incarceration of a part of the gastric body into the abdominal cavity. (b) This fluoroscopic image shows that the stomach was straightened with esophagogastroduodenoscopy. (c) Esophagogastroduodenoscopy detected Cameron's ulcer. The red arrowheads show the ulcer.
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case_images: PMC11136698_01_DEO2-5-e377-g001.jpg
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case_images: The gastric contents were aspirated, and the stomach was straightened (Figures 2a,b). Cameron's ulcer was observed, which presented as a circular and linear ulcer in the gastric body (Figure 2c).
case_images: Imaging findings on readmission (a) Computed tomography shows hiatal hernia and incarceration of a part of the gastric body into the abdominal cavity. The red arrow shows the incarceration of a part of the gastric body into the abdominal cavity, and the yellow arrow shows the compressed duodenum. (b) This fluoroscopic image shows the insertion of the esophagogastroduodenoscope into the duodenum to straighten the stomach. The red arrow shows the incarceration of a part of the gastric body into the abdominal cavity, and the yellow arrows show the compressed duodenum. (c) Esophagogastroduodenoscopy detected severe Cameron's ulcer. The red arrowheads show the ulcer. The yellow arrow points in the direction of the gastric antrum. AW: anterior wall, PW: posterior wall.
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case_images: PMC11136698_01_DEO2-5-e377-g004.jpg
case_images: deo2377-fig-0003
case_images: She was readmitted after confirmation of the same situation on computed tomography (Figure 3a). After the placement of a gastric tube, another esophagogastroduodenoscopy was conducted under fluoroscopy, and the stomach was straightened (Figure 3b). The second esophagogastroduodenoscopy showed a more severe Cameron's ulcer than the first, with reverse incarceration of a part of the gastric body into the abdominal cavity (Figure 3c).
case_images: Operative findings (a) The incarceration of a part of the gastric body had been reduced at the time of surgery. The red arrowheads indicate an esophageal hiatus. The red arrow shows the pylorus. (b) The yellow arrows show the fundus cuff created by Toupet fundoplication. The yellow arrow shows Toupet fundoplication.
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case_images: PMC11136698_01_DEO2-5-e377-g002.jpg
case_images: deo2377-fig-0004
case_images: The patient underwent laparoscopic Toupet fundoplication via a transabdominal approach 4 days after readmission (Figures 4a,b). Inverse incarceration of a part of the gastric body was reduced by preoperative conservative treatment (Figure 4a).