2016 Volume 36 Issue 5 Pages 931-935
A 74-year-old man presented to our hospital complaining of back pain. He had previously undergone a descending aortic graft replacement and omentoplasty for an infected aneurysm. Abdominal plain radiography and computed tomography revealed a diaphragmatic hernia with prolapse of the stomach. The patient was placed under observation because he did not have any abdominal symptoms at the time. Three days after hospitalization, however, he started vomiting and was referred to the surgical department. He was diagnosed as having an incarcerated diaphragmatic hernia, and emergency laparotomy was performed. We found a dilated diaphragmatic aortic hiatus, with prolapse and incarceration of most of the stomach through the hiatus. We returned the herniated organ to the abdominal cavity and closed the diaphragmatic hernia hiatus. As the reason for the internal hernia in this case, it was considered that the stomach prolapsed into the left thorax through the aortic hiatus as it was retracted by the greater omentum surrounding the aortic graft. We should bear in mind the possibility of diaphragmatic hernia arising as a complication of omentoplasty.
