PEDIATRIC SURGICAL EMERGENCY AND ITS RADIOLOGICAL DIAGNOSIS

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Other Title
  • 小児緊急外科疾患とそのX線像
  • ショウニ キンキュウ ゲカ シッカン ト ソノ Xセンゾウ 16 ショクドウ
  • (16) ESOPHAGEAL HIATUS HERNIA
  • (16) 食道裂孔ヘルニア

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Incarceration or strangulation of the esophageal hiatus hernia is rare and we had not experienced emergency operation of the esophageal hiatus hernia in infants and children until recently.<BR>A 24-day-old femal infant was admitted to the Department of Surgery, Gunma University Hospital on Nov. 11, 1974, with the chief complaint of projectile vomiting since 3rd day of life.<BR>The scout chest film on admission (Fig. 2) revealed large oval and round shadows of air and water densities in the medial and inferior portions of the right hemithorax overlapping with shadows of the heart and the liver. Contrast study disclosed that the gastroesophageal junction was displaced well upward into the posterior mediastinum and the stomach was folded into three parts both at the levels of the body and the antrum in the thorax (Fig. 3). Because of the contrast material did not go into the duodenum, incarceration and obstruction in the esophageal hiatus hernia was suspected and emergency operation was performed. At laparotomy, the entire stomach and the first portion of the duodenum was herniated in the posterior mediastinum but reduction of the herniated stomach was not difficult and no strangulated viscera were found. The crural repair and gastropexy were successfully carried out. She was discharged on Dec. 3rd. and well seven months after the operation.

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