Gastric perforation secondary to an incarcerated paraesophageal hernia
Abstract Background Paraesophageal hernias are usually asymptomatic; however, they can cause serious complications such as necrosis or incarceration-induced perforation. Necrosis usually occurs in the incarcerated portion of the hernia. Here, we report the case of a patient with gastric necrosis sec...
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| Language: | English |
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Japan Surgical Society
2019-06-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-019-0653-2 |
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| author | Shota Fukai Tadao Kubota Ken Mizokami |
| author_facet | Shota Fukai Tadao Kubota Ken Mizokami |
| author_sort | Shota Fukai |
| collection | DOAJ |
| description | Abstract Background Paraesophageal hernias are usually asymptomatic; however, they can cause serious complications such as necrosis or incarceration-induced perforation. Necrosis usually occurs in the incarcerated portion of the hernia. Here, we report the case of a patient with gastric necrosis secondary to an incarcerated paraesophageal hernia in which the necrotic lesion was outside the hernia sac. Case presentation A 91-year-old woman presented with severe abdominal pain and vomiting. A physical examination showed hypotension and a diffusely tender and rigid abdomen. Computed tomography showed a paraesophageal hernia, massive ascites, and free air around the stomach. A laparotomy was performed to treat the upper gastrointestinal perforation. The stomach was incarcerated within the paraesophageal hernia sac. After reducing the stomach, we identified a large perforation on the posterior wall of the gastric fundus. Full-thickness necrosis involving part of the stomach necessitated total gastrectomy. She remained physiologically unstable and her condition deteriorated; she died 2 days postoperatively. Conclusions A hiatal hernia can be associated with an ischemic gastric perforation outside the hernia sac. |
| format | Article |
| id | doaj-art-61fc819e145b4e80a758d7ae27f1fa11 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2019-06-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-61fc819e145b4e80a758d7ae27f1fa112025-08-20T02:52:30ZengJapan Surgical SocietySurgical Case Reports2198-77932019-06-01511510.1186/s40792-019-0653-2Gastric perforation secondary to an incarcerated paraesophageal herniaShota Fukai0Tadao Kubota1Ken Mizokami2Department of Surgery, Tokyo Bay Medical CenterDepartment of Surgery, Tokyo Bay Medical CenterDepartment of Surgery, Tokyo Bay Medical CenterAbstract Background Paraesophageal hernias are usually asymptomatic; however, they can cause serious complications such as necrosis or incarceration-induced perforation. Necrosis usually occurs in the incarcerated portion of the hernia. Here, we report the case of a patient with gastric necrosis secondary to an incarcerated paraesophageal hernia in which the necrotic lesion was outside the hernia sac. Case presentation A 91-year-old woman presented with severe abdominal pain and vomiting. A physical examination showed hypotension and a diffusely tender and rigid abdomen. Computed tomography showed a paraesophageal hernia, massive ascites, and free air around the stomach. A laparotomy was performed to treat the upper gastrointestinal perforation. The stomach was incarcerated within the paraesophageal hernia sac. After reducing the stomach, we identified a large perforation on the posterior wall of the gastric fundus. Full-thickness necrosis involving part of the stomach necessitated total gastrectomy. She remained physiologically unstable and her condition deteriorated; she died 2 days postoperatively. Conclusions A hiatal hernia can be associated with an ischemic gastric perforation outside the hernia sac.http://link.springer.com/article/10.1186/s40792-019-0653-2Paraesophageal herniaGastric perforationGastrectomy |
| spellingShingle | Shota Fukai Tadao Kubota Ken Mizokami Gastric perforation secondary to an incarcerated paraesophageal hernia Surgical Case Reports Paraesophageal hernia Gastric perforation Gastrectomy |
| title | Gastric perforation secondary to an incarcerated paraesophageal hernia |
| title_full | Gastric perforation secondary to an incarcerated paraesophageal hernia |
| title_fullStr | Gastric perforation secondary to an incarcerated paraesophageal hernia |
| title_full_unstemmed | Gastric perforation secondary to an incarcerated paraesophageal hernia |
| title_short | Gastric perforation secondary to an incarcerated paraesophageal hernia |
| title_sort | gastric perforation secondary to an incarcerated paraesophageal hernia |
| topic | Paraesophageal hernia Gastric perforation Gastrectomy |
| url | http://link.springer.com/article/10.1186/s40792-019-0653-2 |
| work_keys_str_mv | AT shotafukai gastricperforationsecondarytoanincarceratedparaesophagealhernia AT tadaokubota gastricperforationsecondarytoanincarceratedparaesophagealhernia AT kenmizokami gastricperforationsecondarytoanincarceratedparaesophagealhernia |