Esophagus Hiatus Hernia after Laparoscopic Total Gastrectomy

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  • 腹腔鏡下胃全摘術1年後に傍食道裂孔ヘルニアを発症した1例

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We report on a rare case of esophageal hitus hernia after laparoscopic total gastrectomy (LTG). A 73-year-old man underwent LTG with D2 lymph node dissection and Roux-en-Y (overlap) reconstruction for early gastric cancer. After one year, he was admitted to our hospital with acute abdominal pain. Abdominal CT scan revealed a dilated small intestine prolapsing into the thoracic cavity through the left side of the esophageal hiatus and ischemia of the prolapsed small intestine. He underwent emergency operation based on a diagnosis of strangulation ileus caused by esophageal hiatal hernia. We successfully reduced the prolapsed small intestine back to the abdominal cavity. There was no necrosis in the area. The hernia orifice was occluded by suturing posterior walls of the diaphragm crus and the esophagus was securely fixed by 4 sutures to the diaphragm crus.

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