このエントリーをはてなブックマークに追加
ID 39066
file
title alternative
A Case of Hiatal Hernia with Upside Down Stomach and Incarcerated Transverse Colon Successfully Treated by Laparoscopic Floppy Nissen Fundoplication
creator
Takehara, Hiroki
Maruyama, Kentaro
Nishihara, Masahiro
Kanazawa, Akifumi
Sugimoto, Satoshi
Takayama, Syoichi
Nishihara, Masayoshi
Oka, Hiroshi
subject
upside down stomach
食道裂孔ヘルニア
腹腔鏡下手術
Esophageal hiatal hernia
Laparoscopic surgery
NDC
Medical sciences
abstract
症例は50歳の女性。食後の呼吸困難感のため近医より紹介受診となった。上部消化管造影検査では胃全体が縦隔内に脱出していた。またCT検査では横行結腸の縦隔内への脱出も認めた。以上より,横行結腸嵌入を伴う upside down stomach を呈する食道裂孔ヘルニアと診断し腹腔鏡下手術を行った。食道裂孔より縦隔内の胃や横行結腸を腹腔内に還納したが虚血を疑う所見や狭窄所見は認めなかった。開大した食道裂孔を縫合閉鎖した後にメッシュを用いた食道裂孔の補強と floppy Nissen 法による噴門形成術を施行し,術後経過は良好であった。食道裂孔ヘルニアへの横行結腸嵌入はまれな病態であるが,狭窄・壊死・穿孔のため緊急手術の報告もあり早期に手術治療を行う必要があると考えられた。
abstract
A 50-year-old woman suffering from dyspnea after meals consulted a nearby hospital. In the upper gastrointestinal series, the whole stomach had herniated into the mediastinum. An abdominal CT scan showed the transverse colon to have prolapsed into mediastinum. Esophageal hiatal hernia with upside down stomach and incarcerated transverse colon was diagnosed, and laparoscopic surgery was performed. We returned the stomach and transverse colon to the abdominal cavity, they didn’t become ischemic and constricted. We sutured a dilated opening of hiatal hernia by simple crural closure, additionally closed with a mesh, and a floppy Nissen fundoplication was performed. The postoperative course of the patient was uneventful. Although hiatal hernia with incarcerated transverse colon is very rare, it was necessary that surgical treatment was performed earlier because some emergency laparotomy were reported with transverse colon resection.
journal title
Medical journal of Hiroshima Universtiy
volume
Volume 62
issue
Issue 1-6
start page
1
end page
6
date of issued
2014-12
publisher
広島大学医学出版会
issn
0018-2087
ncid
language
jpn
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright (c) 2014 広島大学医学出版会
department
Graduate School of Biomedical & Health Sciences
他の一覧