Imran Aziz, Dilip Dan, MBBS, FACS, ABS, RECERTIFIED Professor. University of the West Indies
INTRODUCTION: Giant Hiatal hernias are rare occurrences and are equally rare causes of acute pancreatitis.
METHODS AND PROCEDURES: A 57-year-old male with a past history of having an asymptomatic hiatal hernia for 30 years presents with symptoms and signs of mild acute pancreatitis. The patient was managed conservatively and was incidentally found to also have a giant hiatal hernia. Subsequent radiological imaging discovered a 7.7cm x 9.0cm large focal defect on the posterior aspect of the diaphragm, through which the entire stomach protrudes along with loops of small bowel, the transverse colon, omentum and the tail of the pancreas. No other causes were found to be causative of this patient’s pancreatitis in keeping with other case reports of Giant Hiatal hernias being implicated as a rare cause for acute pancreatitis.
RESULTS: This patient underwent a laparoscopic reduction of the visceral contents and repair of the giant hiatal hernia. The video presented demonstrates the sequential reduction of the organs protruding through the hiatus followed by a primary repair. The patient went on to have an uneventful recovery and six months’ post repair continues to show no evidence of recurrence.
CONCLUSION: Giant Hiatal hernias involving the small bowel, stomach, transverse colon, omentum and the pancreas are amenable to laparoscopic primary repair.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95636
Program Number: V413
Presentation Session: Video Loop Day 4
Presentation Type: VideoLoop