A Case of Esophageal Hiatal Hernia Presenting as Upside-Down Stomach Treated Conservatively in Which the Entire Stomach, Transverse Colon, Small Intestine, Pancreas, and Spleen Prolapsed
- VernacularTitle:横行結腸，小腸，膵臓，脾臓とともに全胃が脱出しUpside down stomachを呈する食道裂孔ヘルニアに併発した小腸イレウスに対し保存的治療を施行した１例
- Author:
Emiri SUGIYAMA
1
;
Yasuharu TOKUYAMA
1
;
Hidenori OJIO
1
;
Mana KAWAJIRI
1
;
Kosuke NISHIMURA
1
;
Kazuhiro ISHIHARA
1
Author Information
- From:Journal of the Japanese Association of Rural Medicine 2022;71(4):342-347
- CountryJapan
- Language:Japanese
- Abstract: A woman in her late 80s visited a local physician complaining of nausea, loss of appetite, and constipation. She was referred to our hospital for detailed examination. Computed tomography (CT) revealed that the entire stomach, pancreas, spleen, transverse colon, and small intestine were prolapsed into the mediastinum and left thoracic cavity through the esophageal hiatus, which was dilated. Moreover, the small intestine was narrowed at the hiatus and dilated in the abdominal cavity, presenting ileus. After diagnosing type IV esophageal hiatal hernia with upside-down stomach and starting conservative treatment, the ileus improved and oral intake was resumed. Subsequent CT showed continued prolapse of the pancreas, spleen, transverse colon, small intestine, and entire stomach, but CT taken 5 years earlier had shown similar findings of prolapse. Thus, we decided not to perform surgery and instead opted for close follow-up after discharge. The patient is well without any symptoms of obstruction as of 1.5 years after discharge.
