A Case of Esophageal Hiatal Hernia-induced Repeated Aspiration Pneumonia in an Elderly Patient Successfully Treated with Laparoscopic Fundoplication

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  • Hirai Keitaro
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Yoshinari Daisuke
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Komatsu Kei
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Sato Taisuke
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Tanaka Kazumi
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Takahashi Norifumi
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Ogawa Hiroomi
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Toya Hiroyuki
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Totsuka Osamu
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Sunose Yutaka
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • Takeyoshi Izumi
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine

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Other Title
  • 高齢者で誤嚥性肺炎を繰り返す食道裂孔ヘルニアに対し腹腔鏡下噴門形成術が有用であった１例
  • 高齢者で誤嚥性肺炎を繰り返す食道裂孔ヘルニアに対し腹腔鏡下噴門形成術で有用であった１例
  • コウレイシャ デ ゴエンセイ ハイエン オ クリカエス ショクドウレツコウ ヘルニア ニ タイシ フククウキョウ カ フンモン ケイセイジュツ ガ ユウヨウ デ アッタ 1レイ

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Abstract

An 84-year-old woman was admitted to a hospital near her home for vomiting and fever in January, 2010. She was diagnosed with aspiration pneumonia secondary to a very large esophageal hiatal hernia. Computed tomography showed that the stomach and pancreatic tail had escaped from the abdominal cavity to the mediastinum through the hiatal hernia. Oral ingestion was impossible. An infusion solution and an antibiotic were administered, and her vomiting stopped soon thereafter. However, the vomiting resumed when she began to ingest meals. Because she had been bedridden, due to pneumonia, for a long period of time, she suffered from disuse syndrome. She regained the ability to walk by herself without oxygen after having undergone rehabilitation. She then transferred to our department for surgical repair of her esophageal hiatal hernia in March 2010. A laparoscopic Nissen fundoplication was successfully performed. The postoperative course was uneventful.

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