Laparoscopic Surgery for Parahiatal Type of Diaphragmatic Hernia -Report of a Case-

Masato Aragaki¹⁾²⁾, Tetsufumi Kojima¹⁾, Etsuo Hiraguchi¹⁾, Takahisa Murakami¹⁾, Jou Matsumoto¹⁾ and Kenichi Teramoto¹⁾

Department of Surgery, Hakodate Chuo Hospital¹⁾
Department of Surgical Oncology, Division of Cancer Medicine, Hokkaidou University Graduate School of Medicine²⁾

Parahiatal hernia is an extremely rare abnormality that occurs from muscular diaphragmatic defects separate from the esophageal hiatus. A 70-year-old woman was admitted to the hospital because of the symptom of dysphagia in eating solid meal and vomiting. Chest X-ray film revealed a gastrointestinal gas image in the posterior mediastinal space. A barium esophagram showed a herniated stomach. Initially, we diagnosed this case as paraesophageal hernia, and performed laparoscopic surgery. We found the hernia orifice separately from esophageal hiatus after removal of the cardia of the stomach from the posterior mediastinal space and there was the crus of the diaphragm between the hiatus and the orifice. Hernia orifice was closed with a mesh and the Toupet technique was performed. The patient was discharged without complication at the day after 11. Parahiatal hernia is extremely rare and it is difficult to preoperatively diagnose this. We report this case, Because laparoscopic repair of this entity can be safely and successfully accomplished.

Key words
parahiatal hernia, laparoscopic surgery, diaphragmatic hernia

Reprint requests
Masato Aragaki Department of Surgery, Date Red Cross Hospital
81 Suenaga-cho, Date, 052-8511 JAPAN

Accepted
March 22, 2006

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