Abstract
A 74-year-old woman was admitted to the hospital complaining of dyspnea on working. Chest X-ray showed a mass lesion extending from the mediastinum to the both lung fields which, included gas shadows of the digestive tract in the center. Endoscopy showed that the esophagogastric junction was located at 30 cm from the incisor, and the stomach was twisted longitudinally. Furthermore, linear erosion and round ulcer were observed in the upper stomach. Computed tomography showed a hiatal hernia, including the stomach, small intestine, and transverse colon. Laparoscopy-assisted hernioplasty was performed with the diagnosis of complicated hiatal hernia (type IV) with Cameron lesions. We reduced the incarcerated omentum, small intestine and transverse colon to the abdominal cavity. The size of the esophageal hiatus was 11 × 9 cm. The esophageal hiatus was repaired using a polypropylene mesh/polytetrafluoroethylene sheet. After surgical hernia repair, dyspnea and asthma disappeared, and no gastric erosion and ulcer have been detected endoscopically without medication using proton pump inhibitors.
