Laparoscopic repair of complete intrathoracic stomach with iron deficiency anemia:A case report  

作　　者：Duolikun Yasheng Wubulikasimu Wulamu Yi-Liang Li Airexiati Tuhongjiang Kelimu Abudureyimu 

机构地区：[1]Department of Minimally Invasive Surgery,Hernia and Abdominal Wall Surgery,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang Uygur Autonomous Region,China [2]Department of Gastrointestinal Surgery,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2020年第6期1180-1187,共8页世界临床病例杂志

摘　　要：BACKGROUND Giant paraesophageal hiatal hernias (HH) are very infrequent,and their spectrum of clinical manifestations is large.Giant HH mainly occurs in elderly patients,and its relationship with anemia has been reported.For the surgical treatment of large HH,Nissen fundoplication is the most common antireflux procedure,and the reinforcement of HH repair with a patch (either synthetic or biologic) is still debatable.CASE SUMMARY We report on a case of giant paraesophageal HH in a middle-aged male patient with reflux symptoms and severe anemia.After performing a series of tests and diagnostic approaches,results showed a complete intrathoradc stomach associated with severe iron deficiency anemia.The patient underwent successful laparoscopic hernia repair with mesh reinforcement and Nissen fundoplication.Postoperatively,reflux symptoms were markedly relieved,and the imaging study showed complete reduction of the hernia sac.More importantly,anemia was resolved,and hemoglobin,serum iron and ferritin level were returned to the normal range.The patient kept regular follow-up appointments and remained in a satisfactory condition.CONCLUSION This case report highlights the relationship between large HH and iron deficiency anemia.For the surgical treatment of large HH,laparoscopic repair of large HH combined with antireflux procedure and mesh reinforcement is recommended.BACKGROUND Giant paraesophageal hiatal hernias(HH)are very infrequent,and their spectrum of clinical manifestations is large.Giant HH mainly occurs in elderly patients,and its relationship with anemia has been reported.For the surgical treatment of large HH,Nissen fundoplication is the most common antireflux procedure,and the reinforcement of HH repair with a patch(either synthetic or biologic)is still debatable.CASE SUMMARY We report on a case of giant paraesophageal HH in a middle-aged male patient with reflux symptoms and severe anemia.After performing a series of tests and diagnostic approaches,results showed a complete intrathoracic stomach associated with severe iron deficiency anemia.The patient underwent successful laparoscopic hernia repair with mesh reinforcement and Nissen fundoplication.Postoperatively,reflux symptoms were markedly relieved,and the imaging study showed complete reduction of the hernia sac.More importantly,anemia was resolved,and hemoglobin,serum iron and ferritin level were returned to the normal range.The patient kept regular follow-up appointments and remained in a satisfactory condition.CONCLUSION This case report highlights the relationship between large HH and iron deficiency anemia.For the surgical treatment of large HH,laparoscopic repair of large HH combined with antireflux procedure and mesh reinforcement is recommended.

关 键 词：COMPLETE INTRATHORACIC stomach Giant paraesophageal hiatal HERNIA Iron deficiency ANEMIA NISSEN FUNDOPLICATION Mesh reinforcement Case report 

分 类 号：R655[医药卫生—外科学] R556[医药卫生—临床医学]