A Rare Case of Pancreatitis Due to Trans-Hiatal Herniation of the Pancreas Within a Type IV Hiatal Hernia

Marfan syndrome commonly affects the skeletal, ocular, and cardiovascular systems. Involvement of the gastrointestinal system is known but uncommon. Intervention depends upon the system involved and the severity of symptoms. Special awareness is required for the diagnosis and management of gastrointestinal involvement in these patients. We report a rare case of simultaneous surgical repair of an ascending aortic aneurysm and a type IV hiatal hernia in a 35-year-old man with Marfan syndrome.

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Acute Pancreatitis Secondary to an Incarcerated Paraoesophageal Hernia: A Rare Cause for a Common Problem

Clinical Medicine Insights Case Reports ◽

10.4137/ccrep.s13079 ◽

2014 ◽

Vol 7 ◽

pp. CCRep.S13079 ◽

Cited By ~ 6

Author(s):

Kathryn Boyce ◽

William Campbell ◽

Mark Taylor

Keyword(s):

Acute Pancreatitis ◽

Case Report ◽

Pancreatic Duct ◽

Rare Case ◽

Open Repair ◽

Pancreatic Head ◽

Good Recovery ◽

Type Iv ◽

Rare Case Report ◽

Paraoesophageal Hernia

This is a rare case report of acute pancreatitis secondary to a massive incarcerated paraoesophageal hernia. The pathogenesis resulted from obstruction of the distal pancreatic duct after displacement of the pancreatic head and body into the thorax as part of a Type IV paraoesophageal hernia. Although this condition is rare, the patient made steady progress following laparotomy and open repair of hernia. She made a good recovery after prompt therapy, therefore, this report can be a guide to the diagnosis and treatment of similar conditions.

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Abdome Agudo Obstrutivo por hérnia hiatal tipo IV – Um relato de caso / Obstructive acute abdomen for type IV hiatal hernia – A case report

Brazilian Journal of Health Review ◽

10.34119/bjhrv3n4-311 ◽

2020 ◽

Vol 3 (4) ◽

pp. 10460-10469

Author(s):

Gabriela Ribeiro de Oliveira ◽

Felipe Sant'Maria Naques ◽

Vivian Zampieri de Souza ◽

Rodolpho Cesar Oliveira Mellem Kairala ◽

Maria Clara Nobrega Pereira ◽

...

Keyword(s):

Case Report ◽

Hiatal Hernia ◽

Acute Abdomen ◽

Type Iv

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PS01.072: IT IS NOT ALWAYS RISKY USING MESH IN THE TREATMENT OF HIATAL HERNIA

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.072 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 69-69

Author(s):

Maximiliano Loviscek ◽

Mauro Acosta ◽

Oscar Crespin ◽

Guido Orbe ◽

Cesar Villamil ◽

...

Keyword(s):

Hiatal Hernia ◽

Conflicts Of Interest ◽

Synthetic Mesh ◽

Gastric Erosion ◽

Type I ◽

Intrathoracic Stomach ◽

Type Iii ◽

Type Iv ◽

Low Incidence

Abstract Background Many studies have shown that the importance of using mesh for paraesophageal hernia repair (PEHR) is to prevent recurrence. Unfortunately, it is associated with high risk of complications such as esophageal or gastric erosion. The aim of this study is to report the results of 38 patients who underwent laparoscopic PEHR with the use of a BioSynthetic mesh (GoreÒ Bio AÒ tissue Reinforcement.USA). Methods Observational, retrospective, single-center cohort study. We analysed retrospectively 38 consecutive patients with diagnosis of symptomatic Hiatal Hernia (HH) treated laparoscopically with an absorbable BioSynthetic mesh, between 2011–2017. The classic radiologic classification was used to classify the HH before surgery. This classification consists in four types/stages (I-IV). I: Sliding HH, II: Paraesophageal HH, III: Mixed form and IV: Intrathoracic stomach—upside-down hernia. All patients with Type III—IV hiatal hernia who underwent laparoscopic PEHR using an absorbable BioSynthetic mesh were included. We evaluated the results after PEHR with a symptoms questionnaire using a score 0–4 (Likert scale) and with an esophagogram and an esophagogastroduodenoscopy (EGD) analyzing the surgical success. Success was considered with symptomatic score improvement and/or absence of any symptomatic HH at the esophagogram and/or EGD. Results 38 patients: 7 males and 31 women. Median age: 66 (range 40–71). 12/38 (31,6%) patients had a type III HH and 26/38 (68,4%) a type IV. All these patients had been treated with a laparoscopic PEHR, using an absorbable BioSynthetic mesh as a reinforcement of the crura and Nissen fundoplication. The median follow-up was 12 months. 16/38 (42%) had a follow-up > 24 months. Success was evident in 95% of the patients. We observed 2 recurrences, one with a symptomatic type I HH and the other with an early type III HH recurrence. Conclusion The use of an absorbable synthetic mesh as a reinforcement of the crura in the treatment of the PEH has encouraging good results in the mild term follow up, with an extremely low incidence of complications. Disclosure All authors have declared no conflicts of interest.

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Jejunal Diverticular Perforation Causing Small Bowel Obstruction in a Type 4 Hiatal Hernia: A Rare Case Report of a Nonagenarian Patient and Review of Relevant Literature

Case Reports in Surgery ◽

10.1155/2017/8412927 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Saptarshi Biswas ◽

Shekhar Gogna ◽

Prem Patel

Keyword(s):

Small Bowel ◽

Rare Case ◽

Epigastric Pain ◽

Relevant Literature ◽

Exploratory Laparotomy ◽

The Past ◽

Type Iv ◽

Intestinal Gas ◽

Mesenteric Side ◽

Rare Case Report

Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum. There are a few published cases of small bowel herniation into the thoracic cavity in the literature. Our patient represents a rare case of an individual diagnosed with type IV PEH with herniation of jejunum with perforated diverticula.

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