Ocampo-Guzmán Luis E, Crisanto-Campos Braulio A, DelCampo-Madariaga Emmanuel M, Biviano-Andrade Karla M
General Surgery, Hospital Regional Universitario de Colima, Colima, MEX.
General Surgery, Unidad de Cirugía y Endoscopia Gastrointestinal Mexicana, Mexico City, MEX.
Cureus. 2025 Jul 6;17(7):e87391. doi: 10.7759/cureus.87391. eCollection 2025 Jul.
Type IV hiatal hernia represents a complex and rare form of hiatal hernia, characterized by the protrusion of multiple abdominal organs, such as the stomach, spleen, and colon, into the mediastinum. The surgical approach is complex and requires meticulous technique to reduce the risk of complications and recurrences. We report the case of a patient with a type IV hiatal hernia who underwent laparoscopic repair with crural plasty and placement of Gore Bio-A® absorbable mesh (W. L. Gore & Associates, Newark, DE, USA), anti-reflux surgery (Nissen fundoplication), and simultaneous cholecystectomy. Postoperative evolution was satisfactory, with a one-year follow-up period showing no recurrences or complications. The specific surgical indications for type IV hernias are discussed, along with the current evidence on the use of absorbable meshes in hiatal repair.
IV型食管裂孔疝是一种复杂且罕见的食管裂孔疝形式，其特征是多个腹部器官（如胃、脾和结肠）突入纵隔。手术方法复杂，需要精细的技术以降低并发症和复发风险。我们报告了一例IV型食管裂孔疝患者的病例，该患者接受了腹腔镜修复术，包括膈肌脚成形术和放置戈尔生物A®可吸收补片（美国特拉华州纽瓦克市的W. L. 戈尔公司）、抗反流手术（nissen胃底折叠术）以及同期胆囊切除术。术后恢复情况令人满意，一年的随访期显示无复发或并发症。本文讨论了IV型疝的具体手术指征，以及目前关于在食管裂孔修复中使用可吸收补片的证据。
