The best treatment of this 80-year-old woman with vomiting retrosternal pain and a looped nasogastric tube in her left chest is:
Recurrent volvulus of the stomach into the chest is a serious condition that can lead to incarceration and gangrene. Every attempt should be made to repair this diaphragmatic hernia.
Remove the tube because the patient is now well and discharged.
Evaluate the esophageal myotomy to treat achalasia.
Immediate left thoracotomy to treat perforation.
Consider surgical reduction of volvulus and diaphragmatic repair.
Heart & Pericardium