Incarcerated Giant Hiatal Hernia conditioning hearth shock: case report
<p>Between the hiatal hernias, the type IV is the less frequent by the great defect, but this type had a high incidence of incarceration (5%), and a mortality rate up to 27%. Case: A female patient of 80 years-old was referred to our hospital by septic shock and abdominal</p><p>pai...
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Main Authors: | , , , , , , , , , , |
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Format: | Book |
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Archives of Clinical Gastroenterology - Peertechz Publications,
2018-03-14.
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Summary: | <p>Between the hiatal hernias, the type IV is the less frequent by the great defect, but this type had a high incidence of incarceration (5%), and a mortality rate up to 27%. Case: A female patient of 80 years-old was referred to our hospital by septic shock and abdominal</p><p>pain. At physical exam she refers abdominal and thoracic pain, dyspnea and occasional threw up for the</p><p>last 2 days, with a background of this symptoms the last 5 years, and gastroesophageal refl ux symptoms</p><p>for 10 years. At admission, she referred epigastric and retrosternal pain, dyspnea, with an 02 of 75%, bowel</p><p>sounds in left hemithorax, mean arterial pressure of 50mmHg with the use of norepinephrine. Laboratories</p><p>do not reveal sepsis and CT scan reports a hiatal hernia of 9 cm with left hemithorax occupied by stomach,</p><p>colon, and spleen. A cardiogenic shock by compression was suspected with this data and a laparotomy</p><p>was scheduled. CT scan report was confi rmed and the mentioned organs were reduced to abdomen</p><p>without problems, both diaphragmatic pillars were sutured and a Nissen fundoplication completed. After</p><p>6 hours' norepinephrine was suspended and 48 hours after the patient were discharged uneventfully.</p><p>Conclusion: Giant hiatal hernia must be suspected in patients with chronic abdominal and thoracic</p><p>pain with refl ux symptoms because the complications associated with this disease could have a mortality</p><p>near 30% in case of strangulation and a scheduled surgery could be very safe in the correct moment.</p> |
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DOI: | 10.17352/2455-2283.000049 |