2017 Volume 50 Issue 11 Pages 928-936
Case 1: A 76-year-old man underwent subtotal esophagectomy of the right thoracolaparotomy and gastric tube reconstruction with posterior mediastinal route. He developed sudden onset of abdominal pain and vomiting about eight years after the operation. CT revealed the small intestine prolapsed on the esophageal hiatus into the right thoracic cavity. An emergency laparotomy was performed and the postoperative course was uneventful. Case 2: A 67-year-old man underwent laryngoesophagopharyngectomy without thoracotomy and gastric tube reconstruction with posterior mediastinal route. He presented with sudden abdominal pain about three years after the operation. CT revealed the small intestine was prolapsing on the esophageal hiatus into the left thoracic cavity. An emergency laparotomy was performed and the postoperative course was uneventful. In Japan, a hiatal hernia after esophagectomy has been reported in 31 cases including our case. However, to the best of our knowledge, this is the first report on herniated contents escaping into the right thoracic cavity, as in case 1. The complication rate of hiatal hernias may increase in relation to the spread of laparoscopic surgery. The delay in diagnosing complications sometimes causes a severe outcome, and it is important to prevent hernia consciously at the time of initial surgery.
