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Laparoscopic repair of secondary parahiatal hernia with incarceration of the stomach: a case report.
J Med Case Rep. 2013 Feb 19; 7:50.JM

Abstract

INTRODUCTION

Parahiatal hernia is an extremely rare subtype of hiatal hernia, which in turn is a type of diaphragmatic hernia in adults, and only a few cases have been reported to date. We report the case of a patient who suffered from gastric incarceration through an anatomically separate diaphragmatic defect, immediately lateral to a structurally normal esophageal hiatus, that developed after treatment of a malignant mesothelioma.

CASE PRESENTATION

A 70-year-old Japanese man, who had undergone treatment for a left malignant pleural mesothelioma a year ago at another hospital, was referred to our institution following a 4-day history of epigastric pain. Esophagogastroscopy demonstrated a normal esophagogastric junction, with remarkable stenosis and active gastric ulcer of the gastric body. Histopathological examination of the gastric biopsy specimen confirmed a gastric ulcer. Furthermore, computed tomography revealed a large fluid-filled structure in the retrocardiac space. On the basis of preoperative data, we decided to attempt laparoscopic repair for the gastric volvulus. During surgery, gastric and omental herniation was observed within a peritoneal lined defect immediately lateral to the esophageal hiatus. Dissection near the esophageal hiatus revealed a discrete extrahiatal defect 3cm in diameter immediately adjacent to the left crus of the diaphragm. The parahiatal defect was closed using interrupted nonabsorbable heavy suture. The patient's postoperative course was uneventful, and anastomotic leakage was not observed at postoperative barium swallowing.

CONCLUSIONS

Although preoperative diagnosis of parahiatal hernia is difficult, a laparoscopic approach can be a useful therapeutic procedure not only for paraesophageal hernia but also for parahiatal hernia.

Authors+Show Affiliations

Department of Surgery, Gohshi Hospital, 1-8-20, Nagasu Nishi-Dori, Amagasaki, Hyogo 660-0807, Japan. mtake@hyo-med.ac.jp.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23421939

Citation

Takemura, Masashi, et al. "Laparoscopic Repair of Secondary Parahiatal Hernia With Incarceration of the Stomach: a Case Report." Journal of Medical Case Reports, vol. 7, 2013, p. 50.
Takemura M, Mayumi K, Ikebe T, et al. Laparoscopic repair of secondary parahiatal hernia with incarceration of the stomach: a case report. J Med Case Rep. 2013;7:50.
Takemura, M., Mayumi, K., Ikebe, T., & Hamano, G. (2013). Laparoscopic repair of secondary parahiatal hernia with incarceration of the stomach: a case report. Journal of Medical Case Reports, 7, 50. https://doi.org/10.1186/1752-1947-7-50
Takemura M, et al. Laparoscopic Repair of Secondary Parahiatal Hernia With Incarceration of the Stomach: a Case Report. J Med Case Rep. 2013 Feb 19;7:50. PubMed PMID: 23421939.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic repair of secondary parahiatal hernia with incarceration of the stomach: a case report. AU - Takemura,Masashi, AU - Mayumi,Katsuyuki, AU - Ikebe,Takashi, AU - Hamano,Genya, Y1 - 2013/02/19/ PY - 2012/10/06/received PY - 2013/01/24/accepted PY - 2013/2/21/entrez PY - 2013/2/21/pubmed PY - 2013/2/21/medline SP - 50 EP - 50 JF - Journal of medical case reports JO - J Med Case Rep VL - 7 N2 - INTRODUCTION: Parahiatal hernia is an extremely rare subtype of hiatal hernia, which in turn is a type of diaphragmatic hernia in adults, and only a few cases have been reported to date. We report the case of a patient who suffered from gastric incarceration through an anatomically separate diaphragmatic defect, immediately lateral to a structurally normal esophageal hiatus, that developed after treatment of a malignant mesothelioma. CASE PRESENTATION: A 70-year-old Japanese man, who had undergone treatment for a left malignant pleural mesothelioma a year ago at another hospital, was referred to our institution following a 4-day history of epigastric pain. Esophagogastroscopy demonstrated a normal esophagogastric junction, with remarkable stenosis and active gastric ulcer of the gastric body. Histopathological examination of the gastric biopsy specimen confirmed a gastric ulcer. Furthermore, computed tomography revealed a large fluid-filled structure in the retrocardiac space. On the basis of preoperative data, we decided to attempt laparoscopic repair for the gastric volvulus. During surgery, gastric and omental herniation was observed within a peritoneal lined defect immediately lateral to the esophageal hiatus. Dissection near the esophageal hiatus revealed a discrete extrahiatal defect 3cm in diameter immediately adjacent to the left crus of the diaphragm. The parahiatal defect was closed using interrupted nonabsorbable heavy suture. The patient's postoperative course was uneventful, and anastomotic leakage was not observed at postoperative barium swallowing. CONCLUSIONS: Although preoperative diagnosis of parahiatal hernia is difficult, a laparoscopic approach can be a useful therapeutic procedure not only for paraesophageal hernia but also for parahiatal hernia. SN - 1752-1947 UR - https://www.unboundmedicine.com/medline/citation/23421939/Laparoscopic_repair_of_secondary_parahiatal_hernia_with_incarceration_of_the_stomach:_a_case_report_ L2 - https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-7-50 DB - PRIME DP - Unbound Medicine ER -
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