A Case of Complicated Esophageal Hiatal Hernia with Transverse Mesocolon Hernia

Abstract

A 76-year-old woman was admitted to our hospital because of abdominal bloating and poor oral intake. An abdominal computed tomography showed a complicated esophageal hiatal hernia involving prolapse of the small intestine without dilatation and marked dilatation of the stomach. Upper gastrointestinal imaging showed a small intestine to have passed over the ventral side of the pylorus and protruded into the mediastinum. We made a diagnosis of complicated esophageal hiatal hernia involving prolapse of the small intestine and pyloric stenosis due to compression by the prolapsed small intestine. We performed laparoscopic hernia repair. Intraoperatively, the small intestine had prolapsed in the mediastinum through both an abnormal hiatus in the transverse mesocolon and the esophageal hiatus. The definite diagnosis was complicated esophageal hiatal hernia with transverse mesocolon hernia. After the prolapsed small intestine was returned, both esophageal hiatal hernia and transverse mesocolon hernia were repaired. Here we report a rare case of a complicated esophageal hiatal hernia with transverse mesocolon hernia.