ESOPHAGEALHIATAL HERNIATION OF THE COLON ACCOMPANYING SLYDING HERNIA OF THE STOMACH IN AN INFANT

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The colonic herniation through the esophageal hiatus accompanying sliding hiatal hernia of the stomach is very rear. A seven month-old boy was admitted to our hospital with chronic liver dysfunction. CT was obtained demonstrating a middle part of transverse colon above the diaphragm. The patient had no esophagogastric complaints. Barium enema showed herniation of a transverse colon into thorax through the site compatible with esophageal hiatus same as the CT findings. He underwent operation on one year old electively. We adopted laparoscopic approach. After the left lateral segment of the liver had been elevated, the transverse colon into the thorax through the esophageal hiatus could be seen. The transverse colon was easily reduced from its intrathoracic position and we confirmed the gastroesophageal junction with normal posterior phrenoesophageal ligament and the entire stomach were within the abdominal cavity. A dissection on the crura on the right and anterior side, the intrathoracic hernia sac was reduced. Next, the defect was closed with interrupted sutures. The intra-abdominal esophagus was 3 cm in length with anchor stitch to the crura, so we did not perform any fundoplication. His postoperative clinical course was very good and he has no symptoms past eight months after the operation. We think this is the second report such a condition in infant, and the first paper described the successful treatment by the laparoscopic approach.
名古屋市立大学の論文
2010-09-01

ESOPHAGEALHIATAL HERNIATION OF THE COLON ACCOMPANYING SLYDING HERNIA OF THE STOMACH IN AN INFANT

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