Hiatal Hernia as a Total Gastrectomy Complication.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Gastric cancer is a significant cause of mortality in Brazil, with surgical resection being the primary curative treatment.
• Complications of gastrectomy include fistulas and anastomotic dehiscence; however, hiatal hernia is an infrequently reported complication.
• Hiatal hernia involves abdominal organs protruding through the diaphragm's esophageal hiatus.

Observation:

• A 76-year-old male diagnosed with gastric adenocarcinoma underwent laparoscopic-assisted gastrectomy and D2 lymphadenectomy.
• Post-chemotherapy, the patient presented with severe epigastric pain and nausea.
• CT scan revealed a strangulated hiatal hernia.

Findings:

• The patient successfully underwent emergent hiatal hernia repair.
• No postoperative complications were observed after the hernia repair.
• The patient was discharged nine days post-hernia repair.

Implications:

• This case underscores that hiatal hernia, while rare, can occur as a complication after gastrectomy.
• Prompt diagnosis and surgical intervention are crucial for managing strangulated hiatal hernias post-gastrectomy.
• Further research may be warranted to understand the incidence and predisposing factors of hiatal hernias in post-gastrectomy patients.