Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)
Online ISSN : 1882-9112
Print ISSN : 0385-7883
ISSN-L : 0385-7883
Incarcerated Hiatal Hernia after Laparoscopic Total Gastrectomy
Shohei FujitaMasaru KimataToshiaki TerauchiJunji FurukawaHiroharu Shinozaki
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2019 Volume 44 Issue 1 Pages 143-148

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Abstract

The patient was an 80-year-old man who had undergone laparoscopic total gastrectomy with Roux-en-Y (overlap) reconstruction for gastric cancer. One year later, he presented to us with a history of sudden onset of upper abdominal pain. He was diagnosed as having strangulation of the small bowel caused by incarcerated hernia, and emergency laparoscopic operation was performed. Laparoscopy revealed herniation of the small intestine into the left thoracic cavity through the esophageal hiatus. We then converted the surgical approach to laparotomy and successfully pulled the prolapsed small intestine out into the abdominal cavity and resected the necrotic part of the intestine. The hernia orifice was occluded by suturing the crus of the left diaphragm. Careful review of a routine 6-month postoperative screening CT showed herniation of a segment of the small intestine into the mediastinum through the esophageal hiatus. However, the left pleura was not disrupted. Incarcerated hiatal hernia after laparoscopic total gastrectomy is rare. We describe our case with a review of the relevant literature.

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© 2019 Japanese College of Surgeons
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