Laparoscopic Management of a Strangulated Hiatal Hernia: A Case Report

TL;DR

This case report describes the urgent laparoscopic treatment of a rare, life-threatening type III hiatal hernia in an elderly patient.

Contribution

The novelty lies in highlighting the importance of early surgical intervention for strangulated type III hiatal hernias in emergency settings.

Findings

A large mixed type III hiatal hernia was diagnosed using clinical and radiological methods.

Urgent laparoscopic surgical repair was performed to resolve the strangulation and prevent lethal outcomes.

The case underscores the need for prompt diagnosis and treatment of incarcerated hiatal hernias.

Abstract

Strangulation of type III hiatal hernia is a rare complication that needs immediate surgical intervention to prevent lethal outcomes. The report presents a case of an 85-year-old male who presented to the emergency department with symptoms of severe epigastric pain and multiple episodes of vomiting. Diagnosis was made clinically in addition to radiological imaging, including chest radiography and CT scan that revealed a large mixed type of hiatal hernia, with the majority of the stomach sliding into the thoracic cavity. Management was via urgent surgical repair. Hiatal hernia is a pathological condition characterized by the herniation of abdominal contents through the esophageal hiatus of the diaphragm into the mediastinum. Symptoms vary, and complications may occur; early diagnosis with urgent surgical repair is needed for incarcerated types of hernias. This case report sheds light on the rare complication of type III hiatal hernia. It emphasizes the necessity of early surgical intervention, with the importance of keeping it in mind as a differential diagnosis in emergency department settings.

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