超高齢者の心肺を圧迫する巨大食道裂孔ヘルニア腹腔鏡下手術の1例  [in Japanese] A case of endoscopic surgery in an octogenarian for large esophageal hernia oppressing the lung and heart  [in Japanese]

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Abstract

86歳の女性.動悸と胸部圧迫感と発熱,咳嗽があり食道裂孔ヘルニアに起因する症状と診断され当科に紹介入院となった.胸部X線写真で縦隔に拡大した胃泡と水平面を示す胃液の存在を認めた.巨大な食道裂孔ヘルニア(voluminous hiatus hernia)とバリウム検査で判明した.高齢であり腹腔鏡下手術を選択し,胸腔へ脱出していた横行結腸の一部,全胃,食道胃接合部を腹腔内へ整復し,Modified Nissen fundoplicationの手術を行った.術後4日目に食事開始して10日目に合併症もなく退院した.2年後他疾患での死亡まで再発は認めなかった.呼吸器外科医にとって横隔膜ヘルニア,横隔膜弛緩症,外傷性横隔膜ヘルニアなどに時々遭遇することがあり食道裂孔ヘルニアに通じておくことは重要と考える.

An 86-year-old woman was admitted to our institute for palpitation, chest oppression, fever and cough caused by a large esophageal hernia. Chest X ray showed a huge stomach bubble and niveau in the mediastinum. Barium swallowing upper gastrointestinal examination revealed an esophageal hiatal hernia (a voluminous hiatal hernia (-VHH-)). Considering her age, we treated the VHH by laparoscopy using a modified Nissen fundoplication. She was able to ingest food four days after the operation. She left our institute 10 days after the operation. The patient died from the other disease two years after the operation. There has been no recurrence. Since chest surgeons sometimes encounter diaphragmatic hernias, relaxation of the diaphragm, and traumatic diaphragmatic hernia, it is important to manage esophageal hernia.

Journal

  • The Journal of the Japanese Association for Chest Surgery

    The Journal of the Japanese Association for Chest Surgery 22(4), 35-39, 2008-05-15

    The Japanese Association for Chest Surgery

References:  12

Cited by:  4

Codes

  • NII Article ID (NAID)
    110006783295
  • NII NACSIS-CAT ID (NCID)
    AN10467885
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09190945
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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