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Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia

BACKGROUND: With an incidence of less than 5%, type II paraesophageal hernias are one of the less common types of hiatal hernias. We report a case of a perforated prepyloric gastric ulcer which, due to a type II hiatus hernia, drained into the mediastinum. CASE PRESENTATION: A 61-year old Caucasian...

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Autores principales: Pol, Robert A, Wiersma, Hiske W, Zonneveld, Bas JGL, Schattenkerk, Marinus Eeftinck
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614979/
https://www.ncbi.nlm.nih.gov/pubmed/19063734
http://dx.doi.org/10.1186/1749-7922-3-34
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author Pol, Robert A
Wiersma, Hiske W
Zonneveld, Bas JGL
Schattenkerk, Marinus Eeftinck
author_facet Pol, Robert A
Wiersma, Hiske W
Zonneveld, Bas JGL
Schattenkerk, Marinus Eeftinck
author_sort Pol, Robert A
collection PubMed
description BACKGROUND: With an incidence of less than 5%, type II paraesophageal hernias are one of the less common types of hiatal hernias. We report a case of a perforated prepyloric gastric ulcer which, due to a type II hiatus hernia, drained into the mediastinum. CASE PRESENTATION: A 61-year old Caucasian man presented with acute abdominal pain. On a conventional x-ray of the chest a large mediastinal air-fluid collection and free intra-abdominal air was seen. Additional computed tomography revealed a large intra-thoracic air-fluid collection with a type II paraesophageal hernia. An emergency upper midline laparotomy was performed and a perforated pre-pyloric gastric ulcer was treated with an omental patch repair. The patient fully recovered after 10 days and continues to do well. CONCLUSION: Type II paraesophageal hernia is an uncommon diagnosis. The main risk is gastric volvulus and possible gastric torsion. Intrathoracic perforation of gastric ulcers due to a type II hiatus hernia is extremely rare and can be a diagnostic and treatment challenge.
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spelling pubmed-26149792009-01-08 Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia Pol, Robert A Wiersma, Hiske W Zonneveld, Bas JGL Schattenkerk, Marinus Eeftinck World J Emerg Surg Case Report BACKGROUND: With an incidence of less than 5%, type II paraesophageal hernias are one of the less common types of hiatal hernias. We report a case of a perforated prepyloric gastric ulcer which, due to a type II hiatus hernia, drained into the mediastinum. CASE PRESENTATION: A 61-year old Caucasian man presented with acute abdominal pain. On a conventional x-ray of the chest a large mediastinal air-fluid collection and free intra-abdominal air was seen. Additional computed tomography revealed a large intra-thoracic air-fluid collection with a type II paraesophageal hernia. An emergency upper midline laparotomy was performed and a perforated pre-pyloric gastric ulcer was treated with an omental patch repair. The patient fully recovered after 10 days and continues to do well. CONCLUSION: Type II paraesophageal hernia is an uncommon diagnosis. The main risk is gastric volvulus and possible gastric torsion. Intrathoracic perforation of gastric ulcers due to a type II hiatus hernia is extremely rare and can be a diagnostic and treatment challenge. BioMed Central 2008-12-08 /pmc/articles/PMC2614979/ /pubmed/19063734 http://dx.doi.org/10.1186/1749-7922-3-34 Text en Copyright © 2008 Pol et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Pol, Robert A
Wiersma, Hiske W
Zonneveld, Bas JGL
Schattenkerk, Marinus Eeftinck
Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia
title Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia
title_full Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia
title_fullStr Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia
title_full_unstemmed Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia
title_short Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia
title_sort intrathoracic drainage of a perforated prepyloric gastric ulcer with a type ii paraoesophageal hernia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614979/
https://www.ncbi.nlm.nih.gov/pubmed/19063734
http://dx.doi.org/10.1186/1749-7922-3-34
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