Incarcerated hiatal hernia - A rare postoperative complication following gastrectomy for stomach cancer. A case report and literature review

A Rare Transverse Colon Hiatal Herniation as a Complication of an Esophagectomy

Hiatal herniations involving the transverse colon are a rare condition. This case study explores the hiatal herniation of the transverse colon as a complication of an esophagectomy through the prosection findings of a 91-year-old male anatomical donor ("donor") who had a documented esophagectomy procedure due to esophageal adenocarcinoma. A thorough dissection of the abdomen and thorax confirmed that a large portion of the esophagus was removed during an esophagectomy, and the remaining cervical portion was reconnected to the stomach in the posterior mediastinum of the thoracic cavity. A type IV hiatal hernia involving the transverse colon and greater omentum was also noted. This study aims to evaluate the donor's noted esophageal hiatal herniations and how surrounding atypical anatomy may be correlated with the history of a completed esophagectomy.

Strangulated Bowel Obstruction Due to Hiatal Hernia After Laparoscopic Total Gastrectomy

Laparoscopic total gastrectomy results in more internal hernias than open surgery. However, there are few reports of incarcerated hiatal hernia after laparoscopic total gastrectomy. Here, we report a case of a 79-year-old male who underwent urgent surgical intervention for a strangulated intestinal obstruction due to an incarcerated hernia through the esophageal hiatus following laparoscopic total gastrectomy. In this case, an esophageal hiatal hernia was present before gastrectomy, but was not repaired. Additionally, the patient experienced significant weight loss after gastrectomy. Preoperative hiatal hernia and marked postoperative weight loss may pose risks.

Hand-assisted laparoscopic surgery for an esophageal hiatal hernia with incarcerated transverse colon presenting after laparoscopic gastrectomy: a case report

BACKGROUND

Esophageal hiatal hernia (EHH) presenting after gastrectomy for carcinoma is a type of internal hernia and very rare. There have been no published reports on the use of hand-assisted laparoscopic surgery (HALS) for the treatment of an incarcerated EHH that presented after a gastrectomy. Herein, we report a rare case of HALS performed for an incarcerated EHH presenting after a laparoscopic gastrectomy.

CASE PRESENTATION

This case report presents the case of a 66-year-old man who underwent hernia repair for an incarcerated hernia that presented after he underwent a laparoscopic proximal gastrectomy with double-tract reconstruction for cancer in the esophagogastric junction. Emergency laparoscopic hernia repair was performed and herniation of the transverse colon into the left thoracic cavity through a hiatal defect was confirmed. Since it was difficult to return the transverse colon into the abdominal cavity using forceps, the procedure was converted to HALS and the transverse colon was pulled back into the abdominal cavity. The hernia defect was closed using a non-absorbable suture. The postoperative course was uneventful, and the patient was discharged on the fourth postoperative day.

CONCLUSIONS

The HALS approach provides the tactile experience of an open surgery combined with the benefits of a laparoscopic procedure such as good visualization and low invasiveness. In this case, when the transverse colon that had herniated into the left hemithorax was returned to the abdominal cavity, damage to the transverse colon was avoided by using the hand. Hence, HALS was safely performed to repair an incarcerated EHH after gastrectomy.