A Case of an Incarcerated Diaphragmatic Hernia After Thoracoscopic and Laparoscopic Esophagectomy for Esophageal Cancer

Abstract

A 71-year-old man underwent thoracoscopic and laparoscopic subtotal esophagectomy with reconstruction using a gastric tube through the retro-mediastinal route for esophageal cancer which was performed elsewhere one year and a half previously. He was admitted to our hospital with continuous nausea and abdominal pain from two days previously. Computed tomography (CT) revealed prolapse of the transverse colon into the left thoracic cavity through the esophageal hiatus on the left side of the gastric tube. He was diagnosed as having an incarcerated diaphragmatic hernia and an emergency operation performed. The prolapsed transverse colon was reduced to the abdominal cavity and the diaphragmatic defect was directly sutured laparoscopically. A diaphragmatic hernia after surgery for esophageal cancer is a rare but life-threatening complication. Immediate diagnosis and treatment are therefore important.