Black oesophagus, upside-down stomach and cameron lesions: cascade effects of a large hiatal hernia

2021 ◽  
Vol 14 (11) ◽  
pp. e246496
Author(s):  
Smit Sunil Deliwala ◽  
Murtaza S Hussain ◽  
Anoosha Ponnapalli ◽  
Ghassan Bachuwa ◽  
Grigoriy E Gurvits
Keyword(s):  
Hiatal Hernia ◽  
Gastric Volvulus ◽  
Outlet Obstruction ◽  
Low Flow ◽  
Compensatory Mechanisms ◽  
Acute Exacerbations ◽  
Paraesophageal Hiatal Hernia ◽  
Black Oesophagus ◽  
Cascade Effects ◽  
Cameron Lesions

Acute oesophageal necrosis, black oesophagus (BE) or Gurvits syndrome (GS) is a rare form of severe oesophagitis appearing as a striking circumferential discolouration of distal mucosa with various proximal extensions abruptly terminating at the gastro-oesophageal junction. It is most commonly associated with acute exacerbations of medical comorbidities, while associations with altered gut anatomy are rare. We present a unique constellation of BE, Cameron ulcers (CU), and gastric volvulus from a large paraesophageal hiatal hernia. Our patient recently recovered from COVID-19 and was malnourished and frail, while the expanding paraesophageal hiatal hernia turned into an acute organoaxial gastric volvulus with accompanying outlet obstruction. In low-flow post-COVID coagulopathic states, compensatory mechanisms may lack against gastric stunning and sudden massive reflux on the oesophagus. We additionally performed a systematic review and discovered additional cases with coexistent volvulus and paraesophageal hernia, although there are no previous reports of BE with CU, which makes this study the first.

Congenital paraesophageal hiatal hernia with intrathoracic gastric volvulus in an infant: a case report with radiographic sequence

2007 ◽  
Vol 24 (4) ◽  
pp. 467-470 ◽  
Author(s):  
Jiledar Rawat ◽  
Kumar A. Rashid ◽  
Shandip Kumar Sinha ◽  
Sarita Singh ◽  
Dhiraj Parihar
Keyword(s):  
Case Report ◽  
Hiatal Hernia ◽  
Gastric Volvulus ◽  
Paraesophageal Hiatal Hernia

scholarly journals Type IV paraesophageal hiatal hernia and organoaxial gastric volvulus

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Alison Zachry ◽  
Alan Liu ◽  
Sabiya Raja ◽  
Nadeem Maboud ◽  
Jyotu Sandhu ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Nasogastric Tube ◽  
Epigastric Pain ◽  
Symptomatic Relief ◽  
Gastroesophageal Junction ◽  
Gastric Volvulus ◽  
Longitudinal Axis ◽  
Additional Time ◽  
Type Iv ◽  
Paraesophageal Hiatal Hernia

Organoaxial gastric volvulus occurs when the stomach rotates on its longitudinal axis connecting the gastroesophageal junction to the pylorus. With that, the antrum of the stomach usually rotates in the opposite direction in rela-tion to its fundus (1). This phenomenon has often been known to be associated with diaphragmatic defects (2) Importantly, abnormal rotation of the stomach of more than 180° is a life threatening emergency that may create a closed loop ob- struction which may result in incarceration leading to strangulation, and hence, a surgical emergency. We present the case of a middle-aged female who presented with organoaxial gastric volvulus and had an associated Type IV paraesophageal hiatal hernia that was treated electively. Normally an emergent gastric volvulus is diagnosed via Borchardt’s classic triad (epigastric pain, unproductive vomiting and diffculty inserting a nasogastric tube); however in this patient the nasogastric tube (NGT) was passed into the antrum which allowed additional time for resusci-tation with fuids and other symptomatic relief.

Paraesophageal Hiatal Hernia with Upside-Down Stomach Treated by Laparoscopic Surgery

2017 ◽  
Vol 68 (1) ◽  
pp. 46-51
Author(s):  
Kazutaka Kadoya ◽  
Toshiaki Tanaka ◽  
Satoru Matono ◽  
Naoki Mori ◽  
Haruhiro Hino ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hiatal Hernia ◽  
Paraesophageal Hiatal Hernia

scholarly journals Acute Esophageal Necrosis Secondary to a Paraesophageal Hernia

2021 ◽  
pp. 594-597
Author(s):  
Chris J. Li ◽  
Benjamin B. Claxton ◽  
Peter Block ◽  
Sean Reilly ◽  
Scott Manski ◽  
...  
Keyword(s):  
Paraesophageal Hernia ◽  
Gastric Volvulus ◽  
Gastrointestinal Symptoms ◽  
Antibiotic Use ◽  
Causative Factor ◽  
Low Flow ◽  
Barium Swallow ◽  
Esophageal Mucosa ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis

Acute esophageal necrosis (AEN) or “black esophagus” is a rare clinical entity caused by necrosis of distal esophageal mucosa stemming from esophageal ischemia. Possible etiologies are broad but most commonly include possible triggers of low-flow vascular states in the esophagus, including infections, broad-spectrum antibiotic use, and gastric volvulus, among others. Patients most commonly present clinically with acute onset hematemesis and melena. Here, we describe a patient who initially presented with multiple nonspecific gastrointestinal symptoms, including abdominal pain and nausea, that progressed over a 10-day period, culminating in multiple episodes of hematemesis prior to presentation. Endoscopic evaluation confirmed the diagnosis of AEN and unveiled a possible paraesophageal hernia (PEH) as the causative factor. A subsequent videofluoroscopic barium swallow was utilized to better characterize the upper gastrointestinal anatomy and confirmed the PEH as a likely etiology. Esophagogastroduodenoscopy (EGD) can often identify PEH independently, but in patients with AEN secondary to a possible, but unclear, PEH on EGD, a videofluoroscopic barium swallow is an appropriate and useful next step in confirming the diagnosis. While treatment of AEN traditionally involves fluid resuscitation, intravenous protein pump inhibitors, and total parenteral nutrition, surgical intervention is often indicated in patients who have a contributing and symptomatic PEH.

Advances in the Management of Acute Asthma in Children

1996 ◽  
Vol 17 (7) ◽  
pp. 227-234
Author(s):  
Shirley J. Murphy ◽  
H. William Kelly
Keyword(s):  
Acute Asthma ◽  
Airflow Obstruction ◽  
Low Flow ◽  
Early Introduction ◽  
Diagnosis And Management ◽  
Current State ◽  
Systemic Corticosteroids ◽  
Acute Exacerbations ◽  
National Heart Lung ◽  
Alveolar Hypoventilation

In 1991, the National Heart, Lung and Blood Institute's National Asthma Education Program (NAEP) published "Guidelines for the Diagnosis and Management of Asthma" recommended by an expert panel. This was followed in 1992 by the publication of the "Internal Consensus Report on Diagnosis and Management of Asthma" (ICR). These reports reviewed the current state of knowledge and established the goals of therapy for both chronic asthma and acute exacerbations. This article will provide an update on the research that has been published since those recommendations. The first NAEP guidelines established three goals for the treatment of acute asthma: Rapid reversal of airflow obstruction, correction of significant hypoxemia, and reduction of the rate of recurrent severe asthma symptoms. The ICR added two additional goals: Restoration of lung function to normal as soon as possible and development of a written plan of action in case of a further exacerbation. Both reports concluded that these goals could be accomplished best by aggressive use of inhaled selective beta2-agonists and early introduction of systemic corticosteroids (in certain patients at home). The liberal use of low-flow oxygen was considered safe; it often easily corrects the hypoxemia produced by the alveolar hypoventilation and the mismatch in ventilation/perfusion (V/Q) that frequently accompanies acute asthma exacerbations.

Laparoscopic Treatment of Paraesophageal Hiatal Hernia With Incarceration of the Pancreas and Jejunum

2007 ◽  
Vol 17 (4) ◽  
pp. 313-316 ◽  
Author(s):  
Nobumi Tagaya ◽  
Masatsugu Tachibana ◽  
Hiroaki Kijima ◽  
Yasuharu Kakihara ◽  
Kiyoshige Hamada ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Laparoscopic Treatment ◽  
Paraesophageal Hiatal Hernia
Sign in / Sign up

Export Citation Format

Share Document