title: Laparoscopic Repair and Percutaneous Endoscopic Gastrostomy to Treat Giant Esophageal Hiatal Hernia with Gastric Obstruction: A Case Report.
abstract: We describe a 74-year-old man with repeated aspiration pneumonia who developed gastric obstruction due to giant esophageal hiatal hernia (EHH). We repaired the giant EHH by laparoscopic surgery and subsequently anchored the stomach to the abdominal wall by percutaneous endoscopic gastrostomy (PEG) using gastrofiberscopy. Thereafter, the patient resumed oral intake and was discharged on postoperative day 21. At two years after these procedures, the patient has adequate oral intake and lives at home. Because this condition occurs more frequently in the elderly with comorbidities, laparoscopic surgery contributes to minimally invasive treatment. Furthermore, the procedure combined with concurrent gastropexy via PEG is useful for treating patients who have difficulty swallowing and for preventing recurrent hernia.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hamai
authors.forename: Jun
authors.initials: J
authors.lastname: Hihara
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.forename: Takaoki
authors.initials: T
authors.lastname: Furukawa
authors.forename: Ichiko
authors.initials: I
authors.lastname: Yamakita
authors.forename: Yuta
authors.initials: Y
authors.lastname: Ibuki
authors.forename: Morihito
authors.initials: M
authors.lastname: Okada
mesh_terms: D000368:Aged; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005774:Gastrostomy / Q000379:methods*; D006551:Hernia, Hiatal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome