INTRATHORACIC GASTRIC PERFORATION IN RECURRENT hiatal hernia: CASE REPORT

• DOI: 10.22533/at.ed.159357230208

• Palavras-chave: Recurrent Hiatal Hernia, Laparoscopic Fundoplication, Intrathoracic Gastric Perforation

• Keywords: Recurrent Hiatal Hernia, Laparoscopic Fundoplication, Intrathoracic Gastric Perforation

• Abstract:

  With up to 57% radiological recurrence rate in some studies, the management of hiatal hernia still lacks consistency in the literature. Among the complications of recurrence, intrathoracic gastric perforation secondary to strangulation of the herniated content can lead to ventilatory instability and offer high morbidity and mortality to the patient. Clinical case: Female patient, 78 years old, with a history of hiatal hernia and GERD, approached six months ago with videolaparoscopic fundoplication, evolving with abdominal pain, dyspnea and hemodynamic instability. Diagnosed with recurrent and perforated hernia in the left hemithorax, she underwent total gastrectomy with peritoneostomy, with revision and reconstruction of the Roux-en-Y transit in a second moment. Despite intensive support, the patient died after seven days. Conclusion: Although several surgical strategies have been incorporated in recent years in the management of hiatal hernia cases, the subject remains controversial, requiring constant updating, especially in relation to serious complications, even if they appear late in the procedure.