Laparoscopic surgery of a rare giant paraesophageal hernia: a case report

Introduction and Importance: In the case of a hiatal hernia, the weakening of the esophageal hiatus allowed part of the stomach to slide to the mediastinum. Although the identification of hernias in esophageal hiatus is prone to subjectivity because of anatomical diversity, it is thought to occur often in radiological or endoscopic tests, with a range of 10–20% in the western population. Although asymptomatic, a rare form of hiatal hernia called a paraesophageal hernia (PEH) can be linked to serious, perhaps fatal consequences such as stomach volvulus. Only symptomatic patients should receive surgical treatment. In this case study, the authors present and discuss a giant PEH patient treated with laparoscopic hernial repair and fundoplication. A laparoscopic approach to PEH is important because of the shorter length of stay and fewer complications. Case Presentation: A 46-year-old Asian entered the hospital with symptoms of frequent dyspepsia syndrome, and from a computed tomography (CT) scan, she was diagnosed with a giant paraesophageal hernia. Hernia repair and fundoplication were performed laparoscopically. She was discharged three days after the surgery without significant complications. Clinical Discussion: This report represents a rare case of giant PEH. Although there are some limitations to laparoscopic surgery, it might be associated to fewer complication rate, a shorter stay in the hospital, and a faster recovery. Conclusion: Laparoscopic hernia repair and fundoplication is a safe and applicable surgery for people with symptomatic PEH.