Díez Ares José Ángel, Peris Tomás Nuria, Estellés Vidagany Nuria, Periáñez Gómez Dolores
Cirugia General y del Aparato Digestivo, Hospital Doctor Peset, España.
Cirugía General y Digestiva, Hospital Doctor Peset. Valencia.
Rev Esp Enferm Dig. 2016 Aug;108(8):498-500.
Asymptomatic giant hiatal hernia comprises a relatively common disease, mostly presented in women with 50 years onwards. The therapeutic approach remains controversial in recent years. Under the latest SAGESrevision, all the symptomatic hernias must be repaired, but the symptomatic hiatal hernia definition isnt even now established. We present the case os a A 67 - year old woman with an asymptomatic hiatal hernia, that is admitted to our hospital owing to toracic and abdominal pain. This pain was related with food intake for 6 months. The patient presents a clear worsening in the last 24 hours, with no other asociated symptomatology. Suspecting an incarcerated hiatal hernia with stomach perforation, the patient is taken to theatre for a laparotomy during the early hours. An atypic gastrectomy of the greater curvature with a gastropexy is performed with fixation to the anterior abdominal wall. The surgery is completed with a feeding jejunostomy. The Manegement of giant paraesophagic hernias, still remains as one of the challenge of the esophageal surgeons.
无症状巨大食管裂孔疝是一种相对常见的疾病，多见于50岁及以上的女性。近年来，其治疗方法仍存在争议。根据最新的美国胃肠内镜外科医师学会（SAGES）修订版，所有有症状的疝都必须修复，但有症状的食管裂孔疝的定义至今仍未明确。我们报告一例67岁无症状食管裂孔疝女性患者，因胸腹部疼痛入院。这种疼痛与进食有关，持续了6个月。患者在过去24小时内病情明显恶化，无其他相关症状。怀疑为绞窄性食管裂孔疝伴胃穿孔，患者在凌晨被送往手术室进行剖腹手术。行大弯侧非典型胃切除术并胃固定术，将胃固定于前腹壁。手术最后进行空肠造口术以提供营养。巨大食管旁疝的治疗仍然是食管外科医生面临的挑战之一。
