2020 Volume 45 Issue 2 Pages 161-167
[Case] The patient is an 82-year-old female. An esophageal hiatal hernia, through which the gastric arch invaded the thoracic cavity, was observed for 8 years and the stomach gradually entered the thoracic cavity. The patient developed intra-abdominal hemorrhage post-operatively, but was treated conservatively and discharged on the 18th hospital day. Six months post-operatively, the patient had symptoms of obstruction. The upper gastrointestinal endoscope showed obstruction caused by mesh that entered the esophagus. Laparoscopic mesh removal was performed with an endoscope. Because the esophageal wall was open 2 cm in the long axis direction, all layers were sutured with an absorbent thread. The omentum was covered with a suture and the operation was completed. Subsequently, the stenosis symptoms due to the residual mesh recurred, thus the mesh was removed by upper endoscopy and no stenosis symptoms were observed thereafter. Although placement of mesh for esophageal hiatal hernia is considered a useful method, mesh intrusion is a complication that occurs with a low frequency and is an important complication that will increase in the future.