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Incarcerated Hiatal Hernia with Perforation after Laparoscopic Total Gastrectomy with Roux-en-Y Reconstruction: a Case Report
Journal of Gastric Cancer ; : 132-137, 2019.
Article in En | WPRIM | ID: wpr-740303
Responsible library: WPRO
ABSTRACT
The occurrence of hiatal hernia after total gastrectomy with Roux-en-Y reconstruction is rare. We report the case of a 76-year-old man who presented with dyspnea, vomiting, and fever around 8 days after total gastrectomy with Roux-en-Y reconstruction. Abdominal computed tomography revealed a hiatal hernia containing part of the small intestine in the left thoracic cavity. Emergent reduction and repair of the hiatal hernia were performed later. Operative findings revealed that the Roux limb was incarcerated in the left pleural cavity. Esophagojejunostomy leakage, perforation of the small intestine with transient ischemic change, and pyothorax were also found. Thus, feeding jejunostomy, thoracoscopic decortication, and diversion T-tube esophagostomy were performed. Considering that the main cause of hiatal hernia is blunt dissection with division of the phrenoesophageal membrane, approximating the crus with 1 or 2 figure-8 sutures, according to the size of the defect, to prevent the incidence of hiatal hernia after total gastrectomy may be performed.
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Full text: 1 Index: WPRIM Main subject: Stomach Neoplasms / Sutures / Vomiting / Esophagostomy / Jejunostomy / Incidence / Empyema, Pleural / Thoracic Cavity / Pleural Cavity / Dyspnea Type of study: Incidence_studies / Prognostic_studies Limits: Aged / Humans Language: En Journal: Journal of Gastric Cancer Year: 2019 Type: Article
Full text: 1 Index: WPRIM Main subject: Stomach Neoplasms / Sutures / Vomiting / Esophagostomy / Jejunostomy / Incidence / Empyema, Pleural / Thoracic Cavity / Pleural Cavity / Dyspnea Type of study: Incidence_studies / Prognostic_studies Limits: Aged / Humans Language: En Journal: Journal of Gastric Cancer Year: 2019 Type: Article