THE RARE CASE OF STRANGULATED HIATAL HERNIA AFTER ESOPHAGECTOMY

Abstract

Relevance. In this article we will talk about rare case of strangulated hiatal hernia after esophagectomy.Case descriptions.The patient was hospitalized in the surgical department with a hiatal hernia and adhesive disease. The 9 months ago this patient has a treatment in regional oncological hospital by esophageal carcinoma. The esophagectomy with plastic by Lewis it is normal operation from the patients with esophageal cancer. The patient has a complaint on pain in the chest, vomiting and constipation during two days. The differential diagnosis was between cardiac ischemia, pneumonia, adhesive disease and acute pancreatitis. The blood analysis are don’t have a symptoms of acute inflammation. The contrast intestinal examination multispiral computed tomography scan was revealed the hiatal hernia. The clinical picture of intestinal obstruction has place on next day. The surgery was done. The cause of intestinal obstruction is the strangulated hiatal hernia with prolapse small intestine in left pleural cavity. The resection of necrotic intestin, entero-enteroanastomosis and diaphragm plastic was done. The patient is recovered.Conclusion. The stomach is strangulated in hiatal hernia more often. The strangulated hiatal hernia after Lewis esophagectomy is rare case (no more 4 %). The small intestine in the hernial sac can be rare also (no more 20 % from all cases).

Keywords

• strangulated hiatal hernia
• esophagectomy
• bowel obstruction