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Recurrent hiatal hernia causing small bowel obstruction secondary to herniation into right hemithorax following prior esophagectomy: a case report

Year: 2025

Type: article

Abstract: Hiatal hernias occur when abdominal contents, typically the stomach, herniate through the esophageal hiatus into the mediastinum, causing symptoms such as reflux, chest pain, and dysphagia. Surgical repair aims to restore anatomy and prevent complications such as obstruction or strangulation. While sliding hernias are more common, paraesophageal hernias more frequently necessitate surgery. A case of small bowel herniation into the right hemithorax through a recurrent hiatal hernia in a 77-year-old male with a history of reflux and stage II esophageal adenocarcinoma treated with neoadjuvant chemoradiation, immunotherapy, and esophagectomy. He presented with abdominal pain and dyspnea. Computed tomography imaging revealed small bowel obstruction due to herniation into the thoracic cavity. Emergent intervention included laparoscopic hiatal hernia repair and open small bowel resection. The patient's postoperative course was uneventful, and follow-up imaging at 3 months showed no recurrence. This case underscores the importance of timely surgical intervention in managing complex recurrent paraesophageal hernias.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf381

Authors: Peculiar A Ihunwo, Sarah McIntyre, John K Saunders

Institutions: NYU Langone Health, Bellevue Hospital Center, New York University, Roswell Park Comprehensive Cancer Center, VA NY Harbor Healthcare System

Language: English

Topic: Gastroesophageal reflux and treatments

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000