A CASE OF ESOPHAGEAL HERNIA WITH SEVERE DYSPNEA ON EFFORT

Abstract

We report a case of esophageal hernia with severe dyspnea on effort.
An 80-year-old woman with kyphosis was seen at the hospital because of severe worsening dyspnea on effort with elongation of expiration. Preoperative lung function test showed mixed respiratory dysfunction with per-cent forced expiratory volume in one second (FEV 1.0%) 59.8%, and percent forced vital capacity (%VC) 49% but esophageal endoscopy showed no evidence of reflux esophagitis. Operative findings revealed enlarged hiatus and huge hernia sac as large as 7×10×6cm. Shrinked esophagus was dissected and pulled back into the abdominal cavity. The hiatus was directly closed with sutures and the stomach was fixed to the ligament.
Postoperative course was very smooth, and the dyspnea disappeared. We consider that the cardiopulmonary dysfunction due to the huge esophageeal hernia is a good indication for surgical repair.