A RARE TYPE OF INTERNAL HERNIA - GIANT PARAESOPHAGEAL HIATUS HERNIA
A 65-year-old lady had presented with complaints of chronic cough, chest pain, and discomfort associated with food regurgitation for a few years. She had a history of hypertension and hypothyroidism. After receiving treatment for some time, the symptoms kept recurring and she consulted Dr. Sumanta Dey (Advanced Laparoscopic, Bariatric and GI Surgeon) at Ruby General Hospital. After a thorough evaluation, relevant investigations were advised which revealed a giant Paraesophageal Hiatus Hernia (Type – III).
A giant Paraesophageal Hiatus Hernia (Type – III) is a rare type of internal hernia where the esophagus (food pipe) along with the stomach slides into the chest causing compression over the lungs and heart. Thus, the patient usually presents with chest pain, breathing distress, dry cough, food regurgitation and bloating sensation. Sometimes, the blood supply of the stomach gets blocked and causes severe abdominal pain due to strangulated hernia which is a life-threatening situation.After discussion with the family members and with written informed consent, the lady had been posted for surgery. Laparoscopic Paraesophageal Hernia Repair andToupet’s Fundoplication, a complex surgery had been done. The surgery took almost three hours with negligible blood loss and it was very challenging as the operative area had been adjacent to the heart and lungs. The post-operative period had been uneventful and the lady was back on her feet within four hours followed by her discharge in seventy-two hours. The lady had been very grateful that she recovered from her complaints of many years within a few hours.