Intrathoracic Gastric Perforation Secondary to Strangulated Recurrent Hiatal Hernia: A Case Report of Diagnostic and Therapeutic Challenges
Year: 2025
Type: article
Study design: Case Report
Abstract: This report discusses a rare and challenging case of intrathoracic gastric perforation secondary to a recurrent strangulated hiatal hernia. The patient, a 52-year-old female with a prior history of thoracic and laparoscopic surgery for hiatal and diaphragmatic hernia, presented with epigastric and chest pain, which progressively led to hemodynamic shock. Initially, a pulmonary infection with parapneumonic pleural effusion was suspected. However, further imaging, including a contrast-enhanced computed tomography (CT) scan, revealed bilateral pleural effusion and herniation of the stomach with perforation into the thoracic cavity, which required emergency surgical intervention. Subtotal gastrectomy was performed, followed by peritoneostomy. Postoperatively, the patient was admitted to the intensive care unit. A few days later, she underwent peritoneostomy revision and Roux-en-Y gastrojejunostomy reconstruction. After clinical improvement, she was transferred to the general ward and subsequently discharged, with outpatient follow-up.
Source: Cureus
DOI: 10.7759/cureus.85750
Authors: Larissa Silva Coimbra, Matheus de Oliveira Santos, Giovanna Lima Labate, Aline Sardow Pereira, Thiago Henrique Sigoli Pereira
Institutions: Universidade de São Paulo, Clinics Hospital of Ribeirão Preto
Language: English
Topic: Esophageal and GI Pathology
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411216709