Laparoscopic approach of a giant paraesophageal hernia. A case reportcase report.
Silva-Mendoza CA, Luna-Lugo RF, Guerrero-Barajas I, Chávez-Coss R, González-Gutierrez GI, Baeza-Ruiz D. Laparoscopic approach of a giant paraesophageal hernia. A case report. Am J Med Surg. 2021. 5(2). 1-4.
BACKGROUND. Introduction: Laparoscopic repair is the standard treatment for giant paraesophageal hernia. The repair of paraesophageal hernia is technically challenging and controversial. Case report: A 61 years old female with obesity, who presents 7 months history with partial tolerance to oral intake, dyspnea and 2 months weight loss evolution. Physical exam with abdominal distension, tenderness to palpation in epigastrium, hypoventilation and dullness at the base left lung. Chest X-ray reports a mass with air fluid levels inside. Tomography shows and confirm gastric and colonic content. Therapeutic laparoscopy was performed with intra-abdominal return of viscera, resection of hernia sac and Nissen-type fundoplication. X-ray were taken 48 hours later with full recovery. Conclusion: Paraesophageal hernia can be repair successfully by laparoscopic approach. All symptomatic patients should be surgically treated, when operation is possible. It seems reasonable that asymptomatic or minimally symptomatic patients do not necessarily require surgery and that a more selective approach should be used.
KEY WORDS: Paraesophageal hernia, laparoscopy.