Abstract
A 79-year-old woman presented at our hospital with severe upper abdominal and back pains. On arrival, she was in shock and had a blood pressure of 50/30 mm Hg. Abdominal computed tomography revealed incarceration of the transverse colon and the entire stomach within a hiatal hernia. Emergency surgery was performed. The hernial orifice was 7 cm in diameter. The incarcerated transverse colon was already necrotic on repositioning.
Segmental necrosis was also observed from the terminal ileum to the sigmoid colon. We made a diagnosis of non-occlusive mesenteric ischemia, and subtotal colectomy and iliosigmoidostomy were performed. The crura of the diaphragm were directly sutured to the hernia orifice. In spite of complications such as cerebral infarction and multiple gastric ulcers, the patient was discharged from the hospital 54 days after the operation.
