Kemppainen E, Kiviluoto T
Second Department of Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, FI-00290 Helsinki, Finland.
Surg Endosc. 2000 Jun;14(6):593. doi: 10.1007/s004640000138. Epub 2000 May 8.
Paraesophageal hernia is an unusual disorder of the esophageal hiatus that may be associated with life-threatening mechanical problems. We report a case of a large paraesophageal hernia that presented with acute thoracic herniation and incarceration of the stomach. The patient underwent laparoscopic operation, including reduction of an intrathoracic stomach, hernial sac removal, and tension-free repair of the hiatus with polytetrafluoroethylene (PTFE) mesh. The mesh was fixed with a straight hernia stapler. Postoperatively the patient developed a fatal cardiac tamponade secondary to a coronary vein laceration due to fixation of the mesh with the stapler. Different operative techniques and possibilities for prevention of the complication are discussed.
食管旁疝是一种不常见的食管裂孔疾病，可能伴有危及生命的机械性问题。我们报告一例巨大食管旁疝病例，该病例表现为急性胸腔内疝形成及胃嵌顿。患者接受了腹腔镜手术，包括将胸腔内胃复位、切除疝囊以及用聚四氟乙烯（PTFE）补片对裂孔进行无张力修补。补片用直疝吻合器固定。术后患者因吻合器固定补片导致冠状静脉撕裂，继发致命性心包填塞。文中讨论了不同的手术技术及预防该并发症的可能性。
