Colonic hiatal hernia leading to obstruction after minimally invasive McKeown esophagectomy: a case report

TL;DR

A man developed a rare colonic hiatal hernia after esophagectomy, causing bowel obstruction and requiring surgical repair.

Contribution

This case report highlights a rare complication of hiatal hernia with colonic involvement following minimally invasive esophagectomy.

Findings

A hiatal hernia with transverse colon herniation into the thoracic cavity was diagnosed eight months after esophagectomy.

Surgical repair successfully resolved the obstruction and confirmed the diagnosis.

Prompt surgical intervention is crucial for managing post-esophagectomy hiatal hernias.

Abstract

A 62-year-old man presented with acute abdominal pain and signs of bowel obstruction eight months after undergoing a minimally invasive McKeown esophagectomy for esophageal squamous-cell carcinoma. Initial imaging did not reveal a hernia, and conservative management was unsuccessful. Re-evaluation of imaging suggested a hiatal hernia, and thoracoscopic exploration confirmed a large hernia with the transverse colon herniating into the thoracic cavity. Surgical repair involved reduction of the herniated colon and repair of the diaphragmatic hiatus. The patient recovered uneventfully. This case highlights the diagnostic challenges of post-esophagectomy hiatal hernias and the importance of prompt surgical intervention.

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