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

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    Author
    Shafii, Alexis E.; Agle, Steven C.; Zervos, Emmanuel E.
    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
    URI
    http://hdl.handle.net/10342/3399
    Subject
     Paraesophageal hernia; Intestinal ischemia; Perforated gastic corpus 
    Date
    2009-05-07
    Citation:
    APA:
    Shafii, Alexis E., & Agle, Steven C., & Zervos, Emmanuel E.. (May 2009). Perforated gastric corpus in a strangulated paraesophageal hernia: a case report. , (. Retrieved from http://hdl.handle.net/10342/3399

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    MLA:
    Shafii, Alexis E., and Agle, Steven C., and Zervos, Emmanuel E.. "Perforated gastric corpus in a strangulated paraesophageal hernia: a case report". . . (.), May 2009. March 04, 2021. http://hdl.handle.net/10342/3399.
    Chicago:
    Shafii, Alexis E. and Agle, Steven C. and Zervos, Emmanuel E., "Perforated gastric corpus in a strangulated paraesophageal hernia: a case report,"  , no. (May 2009), http://hdl.handle.net/10342/3399 (accessed March 04, 2021).
    AMA:
    Shafii, Alexis E., Agle, Steven C., Zervos, Emmanuel E.. Perforated gastric corpus in a strangulated paraesophageal hernia: a case report. . May 2009; () . http://hdl.handle.net/10342/3399. Accessed March 04, 2021.
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    • Surgery
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    East Carolina University

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