Incarcerated Giant Hiatal Hernia conditioning hearth shock: case report
Journal Title: Archives of Clinical Gastroenterology - Year 2018, Vol 4, Issue 1
Abstract
Between the hiatal hernias, the type IV is the less frequent by the great defect, but this type had a high incidence of incarceration (5%), and a mortality rate up to 27%. Case: A female patient of 80 years-old was referred to our hospital by septic shock and abdominal pain. At physical exam she refers abdominal and thoracic pain, dyspnea and occasional threw up for the last 2 days, with a background of this symptoms the last 5 years, and gastroesophageal reflux symptoms for 10 years. At admission, she referred epigastric and retrosternal pain, dyspnea, with an 02 of 75%, bowel sounds in left hemithorax, mean arterial pressure of 50mmHg with the use of norepinephrine. Laboratories do not reveal sepsis and CT scan reports a hiatal hernia of 9 cm with left hemithorax occupied by stomach, colon, and spleen. A cardiogenic shock by compression was suspected with this data and a laparotomy was scheduled. CT scan report was confirmed and the mentioned organs were reduced to abdomen without problems, both diaphragmatic pillars were sutured and a Nissen fundoplication completed. After 6 hours’ norepinephrine was suspended and 48 hours after the patient were discharged uneventfully. Conclusion: Giant hiatal hernia must be suspected in patients with chronic abdominal and thoracic pain with reflux symptoms because the complications associated with this disease could have a mortality near 30% in case of strangulation and a scheduled surgery could be very safe in the correct moment.
Authors and Affiliations
Luis Angel Medina Andrade, Vargas Sahagún Cesar Manuel, Rodriguez Rodriguez Carlos Eduardo, Villanueva Solorzano Pedro Leonardo, Méndez Hernández Alberto Robles, Muñoz Bernardo Gutierrez, Brenda Elizabeth Valdez Hernandez, Chevillon Castillo Brigitte Marlene, Jose Eduardo Vallejo Ramirez, Alan Ranferi Campos Cruz, Christian Stefan Tolentino Gonzalez
Keywords
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- EP ID EP326285
- DOI 10.17352/2455-2283.000049
- Views 96
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