Paraesophageal Hiatal Hernia Accompanied with Duodenal and Pancreatic Head Prolapse Causing Obstructive Jaundice—A Case Report—

Abstract

A 74-year-old woman was referred to our hospital for evaluation of obstructive jaundice. Contrast-enhanced computed tomography revealed a paraesophageal hernia with duodenal and pancreatic head prolapse. The common bile duct was obstructed secondary to dislocation of the hepatoduodenal ligament. We performed percutaneous transhepatic bile duct drainage to treat jaundice and subsequent elective laparoscopic surgery for paraesophageal hernia repair. The duodenum and pancreatic head were successfully reduced into the abdominal cavity, and the hernial orifice was sutured and reinforced using a non-absorbable mesh. We also added Toupet fundoplication. The patient's postoperative course was uneventful, and she was discharged 6 days postoperatively. She is asymptomatic, and no recurrence has been observed over 3-year follow-up.