POST ESOPHAGECTOMY DIAPHRAGMATIC HERNIA PRESENTING AS BOWEL OBSTRUCTION – A RARE CASE REPORT.

Dr. Aditya Mantri, Dr. Vikas Warikoo, Dr. Mohit Sharma, Dr. Abhishek Gangopadhyay

Abstract


Hiatus hernia is rare after esophagectomy and due to it’s rarity overlooking this differential in a symptomatic patient can be problematic. Patients can present with recurrent pneumonia, reflux and in the few case small bowel obstruction. Surgery has been the mainstay of treatment for symptomatic hiatus hernias. We present a case of a mechanical small bowel obstruction occurring at the esophageal hiatus in a patient two years after Mc-keown’s esophagectomy. Patient underwent emergency exploratory laparotomy with resolution of small bowel obstruction and persistent hiatus hernia. Complications of these hernias with mechanical small bowel obstructions are even less described in the current literature. It is important to recognize hiatus hernias as potential cause of obstructive symptoms after esophagectomy. While surgical intervention may be inevitable in certain population of patients. High index of clinical suspicion needs to be maintained in clinical practice.


Keywords


Hiatus hernia, esophagectomy, Post-operative , bowel obstruction.

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