Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report
Abstract Background Prolapse of a small part of the proximal stomach through the hiatus into the mediastinum is relatively common. Hiatal hernia involving the postoperative stomach has been reported previously, but the degree of hernia was not so severe, and hiatal hernia involving the prolapse of t...
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| Language: | English |
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Japan Surgical Society
2018-08-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0503-7 |
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| author | Takuro Konno-Kumagai Daisuke Takeyama Toru Nakano Tadashi Sakurai Yusuke Taniyama Takahiro Heishi Chiaki Sato Takashi Kamei |
| author_facet | Takuro Konno-Kumagai Daisuke Takeyama Toru Nakano Tadashi Sakurai Yusuke Taniyama Takahiro Heishi Chiaki Sato Takashi Kamei |
| author_sort | Takuro Konno-Kumagai |
| collection | DOAJ |
| description | Abstract Background Prolapse of a small part of the proximal stomach through the hiatus into the mediastinum is relatively common. Hiatal hernia involving the postoperative stomach has been reported previously, but the degree of hernia was not so severe, and hiatal hernia involving the prolapse of the entire stomach following gastrectomy into the mediastinum has never been reported. We describe a very rare case of large hiatal hernia involving the entire postoperative stomach. Case presentation A 79-year-old man with a history of distal gastrectomy for submucosal benign tumor 40 years ago was referred to our hospital because of dysphagia and weight loss. Computed tomography revealed prolapse of the entire postoperative stomach into the mediastinum, and a radical operation was performed. There was a strong adhesion in the hernial sac of the mediastinum, but only little adhesion due to a previous open surgery in the abdominal cavity was present. After the stomach was pulled into the abdominal cavity, suture cruroplasty and Toupet fundoplication without dissection of the short gastric artery were performed. The patient experienced postoperative paralytic ileus, but the rest of the postoperative course was uneventful and the symptom of dysphagia improved. Conclusions We presented a very rare large hiatal hernia involving the entire postoperative stomach. Toupet fundoplication preserving the short gastric artery could be one of the optimal surgeries to prevent postoperative regurgitation of the remnant stomach. |
| format | Article |
| id | doaj-art-14d6de783e5d419998c51ef717c4f802 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2018-08-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-14d6de783e5d419998c51ef717c4f8022025-08-20T03:32:41ZengJapan Surgical SocietySurgical Case Reports2198-77932018-08-01411510.1186/s40792-018-0503-7Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case reportTakuro Konno-Kumagai0Daisuke Takeyama1Toru Nakano2Tadashi Sakurai3Yusuke Taniyama4Takahiro Heishi5Chiaki Sato6Takashi Kamei7Division of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuAbstract Background Prolapse of a small part of the proximal stomach through the hiatus into the mediastinum is relatively common. Hiatal hernia involving the postoperative stomach has been reported previously, but the degree of hernia was not so severe, and hiatal hernia involving the prolapse of the entire stomach following gastrectomy into the mediastinum has never been reported. We describe a very rare case of large hiatal hernia involving the entire postoperative stomach. Case presentation A 79-year-old man with a history of distal gastrectomy for submucosal benign tumor 40 years ago was referred to our hospital because of dysphagia and weight loss. Computed tomography revealed prolapse of the entire postoperative stomach into the mediastinum, and a radical operation was performed. There was a strong adhesion in the hernial sac of the mediastinum, but only little adhesion due to a previous open surgery in the abdominal cavity was present. After the stomach was pulled into the abdominal cavity, suture cruroplasty and Toupet fundoplication without dissection of the short gastric artery were performed. The patient experienced postoperative paralytic ileus, but the rest of the postoperative course was uneventful and the symptom of dysphagia improved. Conclusions We presented a very rare large hiatal hernia involving the entire postoperative stomach. Toupet fundoplication preserving the short gastric artery could be one of the optimal surgeries to prevent postoperative regurgitation of the remnant stomach.http://link.springer.com/article/10.1186/s40792-018-0503-7Large hiatal herniaPostgastrectomyFundoplication |
| spellingShingle | Takuro Konno-Kumagai Daisuke Takeyama Toru Nakano Tadashi Sakurai Yusuke Taniyama Takahiro Heishi Chiaki Sato Takashi Kamei Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report Surgical Case Reports Large hiatal hernia Postgastrectomy Fundoplication |
| title | Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report |
| title_full | Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report |
| title_fullStr | Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report |
| title_full_unstemmed | Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report |
| title_short | Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report |
| title_sort | hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy a case report |
| topic | Large hiatal hernia Postgastrectomy Fundoplication |
| url | http://link.springer.com/article/10.1186/s40792-018-0503-7 |
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