Abstract Purpose: The study aims to examine the current literature on the surgical management and outcomes associated with POHH (post-operative hiatal hernia) and to present a case of POHH after Ivor-Lewis esophagectomy, to enrich our knowledge on this specific field. Case presentation: A 57-year-old man who underwent neoadjuvant RT-CT and subsequent Ivor-Lewis esophagectomy underwent urgent laparotomy. The operation revealed a strangulated necrotic small bowel inside the diaphragmatic hernia sac and part of the descending colon without ischemia. A total of 40 cm of small bowel was removed. The diaphragmatic defect was repaired with interrupted sutures. The immediate postoperative course was uneventful. Conclusion: POHH is a major surgical complication after Ivor Lewis esophagectomy due to EC (Esophageal cancer), requiring surgical repair. Despite advancements in surgical techniques, diaphragmatic hernia remains a challenging postoperative issue. Since surgery is the only available approach for the treatment of diaphragmatic hernia containing a strangulated abdominal organ, early diagnosis is crucial. Due to a high rate of emergency surgery with life-threatening complications, early surgical repair may be indicated rather than watchful waiting.
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Κίτσου et al. (2024) studied this question.
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