Perforated gastric corpus in a strangulated paraesophageal hernia: a case report
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
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.
Journal of Medical Case Reports,
3(6507),
1-
3. Retrieved from
http://hdl.handle.net/10342/3399
MLA:
Shafii, Alexis E., and Agle, Steven C., and Zervos, Emmanuel E..
"Perforated gastric corpus in a strangulated paraesophageal hernia: a case report". Journal of Medical Case Reports.
3:6507. (1-3),
May 2009.
September 25, 2023.
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," Journal of Medical Case Reports 3, no.
6507 (May 2009),
http://hdl.handle.net/10342/3399 (accessed
September 25, 2023).
AMA:
Shafii, Alexis E., Agle, Steven C., Zervos, Emmanuel E..
Perforated gastric corpus in a strangulated paraesophageal hernia: a case report. Journal of Medical Case Reports.
May 2009;
3(6507):
1-3.
http://hdl.handle.net/10342/3399. Accessed
September 25, 2023.
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Publisher
East Carolina University