Paraesophageal Hernia Causing Colonic Obstruction

Farrell, Bertrand; Gerard, Perry; Bryk, David

doi:10.1097/00004836-199104000-00014

Cited by 10 publications

(7 citation statements)

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“…esophageal hernias containing colon have also been described. 5,6 However, trans-hiatal passage of the large bowel without intrathoracic gastric migration has been noted only once in the literature.…”

Section: Case Reportmentioning

confidence: 99%

Isolated Trans-hiatal Colonic Herniation

Felsher

Brodsky

Brody

2003

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Isolated herniation of the colon through congenital or traumatic diaphragmatic defects are well documented. However, trans-hiatal herniation of the colon in the absence of an intrathoracic stomach has been reported only once. A 67-year-old man presented with intragastric abdominal pain and a chest x-ray film documenting a posterior mediastinal air-fluid level. Computed tomography showed gastrointestinal contents within the thorax. The findings on an upper gastrointestinal film with small bowel follow-through were normal. Finally, a barium enema identified transverse colon within the thoracic cavity. At laparoscopy, the entire transverse colon was reduced with the hernia sac. The crural defect was repaired, and a Toupet fundoplication was performed. A gastropexy was also added. The patient was discharged on postoperative day 2 able to tolerate a regular diet, and he has been asymptomatic for 5 months. This defect most likely represents a congenital deformity of the diaphragm with intact posterior gastric attachments, including the posterior phrenoesophageal ligament. An intact gastric mesentery enabled isolated colonic herniation with retention of the stomach its normal anatomic position. An antireflux procedure was performed in addition to the crural repair because of the circumferential dissection of the esophagus. This article is the second report of an isolated trans-hiatal herniation of the colon and the first report of laparoscopic repair of this entity.

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Section: Case Reportmentioning

confidence: 99%

Isolated Trans-hiatal Colonic Herniation

Felsher

Brodsky

Brody

2003

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…ISB drug treatment is reported primarily in case reports. [8][9][10] Considering the efficacy and adverse effect of the drugs, sometimes it is difficult to choose the proper drugs, especially in geriatric patients. In the present report, finasteride decreased ISBs in geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…MHH of the gastrointestinal tract to middle mediastinum is a rarely reported intrathoracic gastrointestinal disease. [1][2][3][4][5][6][7][8][9] The most common hiatal hernia is a sliding hernia of the stomach, but paraesophageal hernia occasionally occurs. 4,6 Sporadic cases of hiatal hernias of the stomach along with colon or greater omentum or only the colon have been reported in the past.…”

Section: Massive Hiatal Hernia Of Gastrointestinal Tract: a Rare Intrmentioning

confidence: 99%

“…4,6 Sporadic cases of hiatal hernias of the stomach along with colon or greater omentum or only the colon have been reported in the past. 2,3,5,8 In elderly people, increase in laxity of the diaphragmatic cruses forming the esophageal hiatus and high abdominal pressure, which result in acquired enlargement of esophageal hiatus, are considered to be the causes of hiatal hernia as a result of the aging process. 6 Clinical manifestations of hiatal hernia of the gastrointestinal tract vary with the type and organs involved.…”

Section: Massive Hiatal Hernia Of Gastrointestinal Tract: a Rare Intrmentioning

confidence: 99%

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Massive Hiatal Hernia of Gastrointestinal Tract: A Rare Intrathoracic Gastrointestinal Disease

Cheung¹,

Ho²,

Wang

2009

J American Geriatrics Society

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“…13 0.2 rarer cases of paraesophageal hiatal hernias in which the transverse colon might be involved include a report of a patient who had a paraesophageal hernia in which herniation of the splenic flexure led to colonic obstruction. 6 Another report described a rarer event in which a hernia through the aortic hiatus allowed passage of first the stomach and then the colon through the diaphragm. 7 Paraesophageal hiatal hernias can occur, though very seldom, as congenital problems diagnosed in infancy.s They are found predominately as acquired problems in the elderly.…”

Section: -4mentioning

confidence: 99%

Paraesophageal Hernia and Intrathoracic Diverticulitis

Magill

Gazak

2000

The Journal of the American Board of Family Medicine

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Paraesophageal hernia is a potentially lethal condition that has not been previously discussed in the family medicine literature. It accounts for 3.5% to 5 % 1 of all hiatal hernias. Diagnosis of paraesophageal hernia can be difficult. Patients are usually elderly and have symptoms of esophageal reflux or postprandial pain, bloating, and vomiting. The patient might have a history of hiatal hernia.We report here a case of paraesophageal hernia, complicated by herniation of colon into the thorax, with intrathoracic diverticulosis, probable diverticulitis, and myocardial infarction. Family physicians should be aware of the symptoms of paraesophageal hernia so they can promptly diagnose and manage this potentially lethal condition. Case ReportA 90-year-old man was admitted to a community hospital complaining of abdominal pain. The pain was located in the left upper quadrant of the abdomen, and he described it as steady and "aggravating." He had no associated fever and did not report a history of esophageal reflux-type symptoms, but he did have several episodes of vomiting nonbloody fluid. There was no associated diarrhea, constipation, melena, or hematochezia.The patient also complained of intermittent, poorly characterized pain in his left lower anterior thorax, which he said was different from his abdominal pain. He denied exertional chest pain but did complain of shortness of breath when walking up one flight of stairs. He denied orthopnea, paroxysmal nocturnal dyspnea, and edema.He had been released from the hospital 8 days earlier after a 4-day admission for nausea, decreased appetite, and weight loss. At that time he had been given antibiotics for presumed diverticu-

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Paraesophageal Hernia Causing Colonic Obstruction

Cited by 10 publications

References 0 publications

Isolated Trans-hiatal Colonic Herniation

Isolated Trans-hiatal Colonic Herniation

Massive Hiatal Hernia of Gastrointestinal Tract: A Rare Intrathoracic Gastrointestinal Disease

Paraesophageal Hernia and Intrathoracic Diverticulitis

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