A Case of Laparoscopic Hiatal Hernia Surgery for Intrathoracic Omental Herniation Diagnosed by Preoperative CT Scan

Intrathoracic omental herniation is a very rare condition, and only a few reports have demonstrated a laparoscopic approach. The patient, a 53-year-old woman, visited her local doctor because of heartburn and reflux. She underwent chest X-ray and computed tomography (CT) and was diagnosed with intrathoracic omental herniation through the esophageal hiatus. She was referred to our hospital for further examination and treatment. Chest X-ray revealed a well-defined mass in the midline, whereas CT revealed fatty tissue in the posterior mediastinum. No herniation of the stomach into the thorax was observed. Laparoscopic surgery was performed. The greater omentum had entered the right side of the esophageal hiatus. The diameter of the hernial orifice was 5 cm. Direct suturing was performed to close the esophageal hiatus. A preoperative diagnosis of intrathoracic omental herniation was considered important, as it allowed for a safe and effective treatment via laparoscopic surgery.