A Rare Complication of Hiatal Hernia

Transhiatal Herniation of the Pancreas: A Rare Cause of Acute Pancreatitis

“…Other possibilities include volvulus formation or intermittent folding of the pancreatic duct leading to pancreatic secretion against a fixed obstruction, intraductal hypertension, and ensuing inflammation. Incarceration of the pancreas resulting in anoxic injury may also be another mechanism 4-8…”

Asymptomatic isolated partial hiatal herniation of the pancreas: MDCT evaluation and anatomical explanation: Case report and review of literature

“…The body of the pancreas may thus reach, through a partial detachment of its posterior fusion fascia, the posterior, retroperitoneal portion of the esophagogastric junction and herniates into the esophageal hiatus. The proposed mechanisms that lead to total or partial intrathoracic herniation of the pancreas may be multiple: -Failure of closure of the pleuroperitoneal canal as in Bochdalek hernia (Cushieri and Wilson, ; Oliver et al, ). -Traction or pulsion of a vascular pedicle by other organs, with stretching of the transverse mesocolon (Kafka et al, ; Chevallier et al, ; Katz et al, ; Gremmels et al, ; Saxena et al, ; Tagaya et al, ; Maksoud et al, ; Rozas and González, ; Coughlin et al, ). -Persistent pneumoenteric defect in the medial aspect of the right lung base (Coral et al, ). …”

“…Hiatal hernia has been found in as many as 20% of patients undergoing upper gastrointestinal endoscopy (Loffeld and van der Putten, 2002). In contrast, herniation of the pancreas through the gastroesophageal hiatus is an extremely rare condition with no more than eight cases described in the English literature (Kafka et al, 1994;Chevallier et al, 2001;Gremmels et al, 2003;Saxena et al, 2006;Tagaya et al, 2007;Maksoud et al, 2010;Rozas and Gonz alez, 2010;Coughlin et al, 2011) (Table 1), while has been described only one case of isolated pancreatic hiatal hernia (Katz et al, 2002). These patients may remain symptom free (Katz et al, 2002) or may eventually show signs of acute pancreatitis by ischemia caused by the abnormal traction on the pancreas (Chevallier et al, 2001;Tagaya et al, 2007;Maksoud e al., 2010) or by the total incarceration of the gland in a paraesophageal hernia without pancreatic volvulus (Kafka et al, 1994).…”

A Rare Case of Pancreatitis From Pancreatic Herniation

“…Table 1 [3,[7][8][9][10][11][12][13][14][15] lists the cases of acute pancreatitis from pancreatic herniation in hiatal hernias from published literature. All cases were diagnosed based on exclusion of other etiologies for acute pancreatitis.…”