A CASE OF ESOPHAGEAL HIATAL HERNIA WITH INCARCERATION OF THE GASTRIC ANTRUM AND DUODENAL BULB

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  • 自然還納した胃前庭部および十二指腸球部嵌頓食道裂孔ヘルニアの１例

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We report a rare case of esophageal hiatal hernia with incarceration of the gastric antrum and duodenal bulb, which were reduced spontaneously. An 85-year-old woman vomited during the preparation for colonoscopy, and she was admitted to our hospital. She had a history of lumbar spondylosis and neurogenic bladder. During the initial gastrointestinal endoscopy examination, the endoscope was not advanced into the gastric antrum because of deformity of the stomach. Upper gastrointestinal series showed that the gastric fundus, antrum, and duodenal bulb were incarcerated within an esophageal hiatal hernia. The patient was diagnosed with mixed esophageal hiatal hernia with incarceration of the gastric antrum and duodenal bulb. Because she and her family did not consent to an operation and there were no symptoms of the total occlusion and strangulation of the incarcerated bowel, she was administered conservative treatment. Approximately 3 weeks after admission, her appetite improved gradually. Upper gastrointestinal series revealed that the gastric antrum and duodenal bulb were reduced. At the subsequent gastrointestinal endoscopy examination, we were able to advance the endoscope into the second portion of the duodenum ; the endoscopy results revealed that the gastric and duodenal mucosa were normal. The patient was discharged after being treated for neurogenic bladder.

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