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Gastric perforation secondary to an incarcerated paraesophageal hernia

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 t...

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Autores principales: Fukai, Shota, Kubota, Tadao, Mizokami, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557949/
https://www.ncbi.nlm.nih.gov/pubmed/31183595
http://dx.doi.org/10.1186/s40792-019-0653-2
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author Fukai, Shota
Kubota, Tadao
Mizokami, Ken
author_facet Fukai, Shota
Kubota, Tadao
Mizokami, Ken
author_sort Fukai, Shota
collection PubMed
description 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.
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spelling pubmed-65579492019-06-21 Gastric perforation secondary to an incarcerated paraesophageal hernia Fukai, Shota Kubota, Tadao Mizokami, Ken Surg Case Rep Case Report 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. Springer Berlin Heidelberg 2019-06-10 /pmc/articles/PMC6557949/ /pubmed/31183595 http://dx.doi.org/10.1186/s40792-019-0653-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Fukai, Shota
Kubota, Tadao
Mizokami, Ken
Gastric perforation secondary to an incarcerated paraesophageal hernia
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557949/
https://www.ncbi.nlm.nih.gov/pubmed/31183595
http://dx.doi.org/10.1186/s40792-019-0653-2
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