Intrathoracic major duodenal papilla with transhiatal herniation of the pancreas and duodenum:A case report and review of the literature  

作　　者：Tarkan Jger Daniel Neureiter Clemens Nawara Adam Dinnewitzer Dietmar fner Wolfram Lamadé 

机构地区：[1]Department of Surgery,Paracelsus Medical University,5020 Salzburg,Austria [2]Institute of Pathology,Paracelsus Medical University/Salzburger Landeskliniken,5020 Salzburg,Austria [3]Department of Surgery,Helios Spital,88662 überlingen,Germany

出　　处：《World Journal of Gastrointestinal Surgery》2013年第6期202-206,共5页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Transhiatal herniation of the pancreas is an extremely rare condition.In the published literature we found only eleven cases reported in the period of 1958 to 2011.A coincidental hiatal herniation of the duodenum is described in two cases only.To our knowledge,we report the first case with a hiatal herniation of the complete duodenum and proximal pancreas presenting an intrathoracic major duodenal papilla with consecutive intrahepatic and extrahepatic cholestasis.A 72-yearold Caucasian woman was admitted to our department with a hiatal hernia grade Ⅳ for further evaluation.According to our recommendation of surgical hernia repair soon after the diagnosis of a transhiatal herniation of the proximal pancreas and entire duodenum,we had to respect the declared intention of the patient for a conservative procedure.So we were forced to wait for surgical repair within an emergency situation complicated by a myocardial infarction and reduced general condition.We discuss the therapeutic decision making process and a complete literature review of this rare entity.Transhiatal herniation of the pancreas is an extremely rare condition.In the published literature we found only eleven cases reported in the period of 1958 to 2011.A coincidental hiatal herniation of the duodenum is described in two cases only.To our knowledge,we report the first case with a hiatal herniation of the complete duodenum and proximal pancreas presenting an intrathoracic major duodenal papilla with consecutive intrahepatic and extrahepatic cholestasis.A 72-yearold Caucasian woman was admitted to our department with a hiatal hernia grade Ⅳ for further evaluation.According to our recommendation of surgical hernia repair soon after the diagnosis of a transhiatal herniation of the proximal pancreas and entire duodenum,we had to respect the declared intention of the patient for a conservative procedure.So we were forced to wait for surgical repair within an emergency situation complicated by a myocardial infarction and reduced general condition.We discuss the therapeutic decision making process and a complete literature review of this rare entity.

关 键 词：Hiatal HERNIA Paraesophageal HERNIA INTRATHORACIC PANCREAS INTRATHORACIC DUODENUM DIAPHRAGMATIC HERNIA 

分 类 号：R656.6[医药卫生—外科学]