A Case of Esophageal Hiatal Hernia-induced Repeated Aspiration Pneumonia in an Elderly Patient Successfully Treated with Laparoscopic Fundoplication

Abstract

An 84-year-old woman was admitted to a hospital near her home for vomiting and fever in January, 2010. She was diagnosed with aspiration pneumonia secondary to a very large esophageal hiatal hernia. Computed tomography showed that the stomach and pancreatic tail had escaped from the abdominal cavity to the mediastinum through the hiatal hernia. Oral ingestion was impossible. An infusion solution and an antibiotic were administered, and her vomiting stopped soon thereafter. However, the vomiting resumed when she began to ingest meals. Because she had been bedridden, due to pneumonia, for a long period of time, she suffered from disuse syndrome. She regained the ability to walk by herself without oxygen after having undergone rehabilitation. She then transferred to our department for surgical repair of her esophageal hiatal hernia in March 2010. A laparoscopic Nissen fundoplication was successfully performed. The postoperative course was uneventful.