胃壁内気腫を伴う急性胃拡張を起こした食道裂孔ヘルニアの1例

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  • ACUTE DILATATION OF STOMACH WITH INTERSTITIAL GASTRIC EMPHYSEMA IN A PATIENT WITH ESOPHAGEAL HIATAL HERNIA

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Esophageal hiatal hernia has three types, namely the sliding which occurs most commonly, paraesophageal, and the mixed ones. We have experienced a special case of the mixed type. A 70-year-old woman complaining of abdominal pain and vomiting was referred to our hospital for admission. A distention of the upper abdomen and peritoneales Reizsymptom were observed. Roentgenography with gastrographin through gastric tube revealed a large sliding esophageal hiatal hernia, a middle part of the body of stomach located under the diaphragma, and the lower part entering into the upper part of diaphragma through the esophageal hiatal hernia, at where the impaired passage caused acute gastrectasis leading to emphysema in the gastric wall. Aspiration of gastlic juice resulted in conservative remission of acute gastrectasis, and almost complete disappearence of emphysema 2 days after treatment. After remission of pneumonia caused by swallowing erroneously, the lower part of the body of stomach, which entered into the diaphragma through the fistsized hiatus, was pulled down, then suture of the hiatus and gastropexy were performed under general anesthesia.

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