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[Intrathoracic perforation of stomach ulcer in a massive hiatal hernia]
H B Rahr1, J Grønlund, F M Johnsen
1Kirurgisk gastroenterologisk afdeling A og røntgenafdelingen Aalborg Sygehus.
Abstract:
A case of intrathoracic perforation of a chronic gastric ulcer in a hiatus hernia is presented. A 67-year-old woman had suffered from interscapular pain and epigastric discomfort following large meals for four years. During the week before admission, the epigastric and interscapular pain increased, reaching a crescendo in the 24 hours before the patient's arrival in the emergency room. Chest and abdominal x-ray showed free gas and a large hiatus hernia with an intrathoracic stomach. At laparotomy, the stomach was gently returned to the abdominal cavity, and a perforated chronic gastric ulcer was found on the greater curvature. The ulcer was excised, and the diaphragmatic crura were approximated. Apart from wound dehiscence, the postoperative course was uneventful.