title: Hiatal hernia following total gastrectomy with Roux-en-Y reconstruction.
abstract: Hiatal hernias after total gastrectomy for advanced gastric cancer are very rare. We review a case of a 44-year-old male who presented with dyspnea and chest pain 2 days after total gastrectomy, lower esophagectomy, and splenectomy with retrocolic Roux-en-Y reconstruction approached by a left thoracoabdominal incision for gastric cancer at the cardia. Plain and cross-sectional imaging identified a large hiatal hernia protruding into the right thorax containing left-sided transverse colon and small intestine. Our patient underwent a laparotomy, and after hernia reduction the hiatal defect was repaired by direct suturing. He experienced anastomotic leakage and right pyothorax, but recovered. The potential cause is discussed here and the published literature on this rare complication is reviewed briefly.
authors.affiliation: Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan, soichiromurata@live.jp.
authors.forename: S
authors.initials: S
authors.lastname: Murata
authors.forename: M
authors.initials: M
authors.lastname: Yamazaki
authors.forename: C
authors.initials: C
authors.lastname: Kosugi
authors.forename: A
authors.initials: A
authors.lastname: Hirano
authors.forename: Y
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: R
authors.initials: R
authors.lastname: Shiragami
authors.forename: M
authors.initials: M
authors.lastname: Suzuki
authors.forename: K
authors.initials: K
authors.lastname: Shuto
authors.forename: K
authors.initials: K
authors.lastname: Koda
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D005743:Gastrectomy / Q000009:adverse effects*; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D013274:Stomach Neoplasms / Q000601:surgery*
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