Hiatal herniation following total gastrectomy

Bezoar in incarcerated and complicated hiatal hernia

INTRODUCTION

the identification of a 10 cm bezoar in a hiatal hernia is unusual. Hiatal hernias are usually asymptomatic. When signs of strangulation are present the prognosis is unlucky if urgent surgical intervention is not performed. Although sometimes the prognosis is bad because of the advanced state of gastric ischemia.

CASE REPORT

a 67-year-old female patient undergoing Nissen fundoplication with recurrence of hiatal hernia, volvulated and strangulated with giant bezoar inside the hhital hernia sac.

DISCUSSION

despite of poor results, surgical treatment in these cases must be urgent.

Dual incarcerated internal hernias after laparoscopic total gastrectomy with Roux-en-Y reconstruction for gastric cancer

Internal hernia postgastrectomy is an exceedingly rare complication especially in the laparoscopic cohort of patients. Different types of internal hernias have been described, of which, Petersen's and jejunojejunostomy mesenteric defect hernias are the most commonly encountered followed by oesophageal defect and transverse colon mesocolic defect hernias. As the early presentation is always non-specific, late diagnosis of internal hernia has significant implication on morbidity and mortality. Here, we present a rare case of a patient with previous laparoscopy-assisted total gastrectomy presented with features of impending bowel obstruction and bowel ischaemia secondary to dual incarcerated internal hernias. We also reviewed the literature focusing on clinical features of internal hernia, essential CT findings and preventive measures.