Perforated gastric corpus in a strangulated paraesophageal hernia: A case report

Alexis E. Shafii, Steven Agle, Emmanuel E. Zervos

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Article number6507
JournalJournal of Medical Case Reports
Volume3
DOIs
StatePublished - 2009
Externally publishedYes

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Hiatal Hernia
Stomach
Intestinal Perforation
Aortic Rupture
Intestinal Volvulus
Viscera
Abdominal Aortic Aneurysm
Back Pain
Heart Arrest
Abdomen
Hypotension
Abdominal Pain
Hospital Emergency Service
Autopsy
Emergencies
Ischemia
Air

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Perforated gastric corpus in a strangulated paraesophageal hernia : A case report. / Shafii, Alexis E.; Agle, Steven; Zervos, Emmanuel E.

In: Journal of Medical Case Reports, Vol. 3, 6507, 2009.

Research output: Contribution to journalArticle

Shafii, Alexis E. ; Agle, Steven ; Zervos, Emmanuel E. / Perforated gastric corpus in a strangulated paraesophageal hernia : A case report. In: Journal of Medical Case Reports. 2009 ; Vol. 3.
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