Perforated gastric corpus in a strangulated paraesophageal hernia: a case report

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)
Steven C. Agle (Creator)
Alexis E. Shafii (Creator)
Emmanuel E. Zervos (Creator)
East Carolina University (ECU )
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Abstract: Introduction: Patients with paraesophageal hernias often present secondary to chronic symptomatology. Infrequently acute intestinal ischemia and perforation can occur as a consequence of paraesophageal hernias with potentially dire consequences. Case presentation: An 86-year-old obtunded male presented to the emergency department with hypotension and severe back and abdominal pain. An emergency abdominal CT scan was ordered with a presumptive diagnosis of ruptured abdominal aortic aneurysm. CT topograms revealed extensive free intra-abdominal air and herniated abdominal viscera into the right hemithorax. Prior to completion of the CT study the patient sustained a cardiopulmonary arrest. Surgery was consulted but the patient was unable to be revived. Post-mortem examination revealed gross contamination within the abdomen and a giant incarcerated hiatal hernia with organoaxial volvulus and ischemic perforation. Conclusion: Current recommendations call for prompt repair of giant hiatal hernias before they become symptomatic due to the increased risk of strangulation. Torsion of the stomach in large hiatal hernias frequently leads to a fatal complication such as this warranting elective repair as soon as possible. Originally published Journal of Medical Case Reports Vol. 3 No. 6507 May 2009

Additional Information

Journal of Medical Case Reports. 3:6507(May 2009) p. 1-3.
Language: English
Date: 2011
paraesophageal hernia, intestinal ischemia, perforated gastic corpus

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