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Case Report
Giant hiatal hernia: A review of the clinical presentation, surgical technique, and operative video
1 General Surgery, Université Catholic de Louvain, Louvain-la-Neuve, Belgium
2 General Surgery, Europe Hospitals, Brussels, Belgium
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Océane Wautelet
Chaussée de Louvain 718, 53, 1030 Schaerbeek,
Belgium
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Article ID: 100120Z12OW2023
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Wautelet O, Belle KV, Terryn FX. Giant hiatal hernia: A review of the clinical presentation, surgical technique, and operative video. J Case Rep Images Surg 2023;9(1):20– 24.ABSTRACT
Introduction: Giant hiatal hernia represents 0.3–15% of all hiatal hernia. Its complication such as the strangulation of the stomach are life-threatening. Therefore, in most of the cases it must be surgically handled.
Case Report: We report the case of a 74-year-old patient with giant hiatal hernia. He presented with sub-acute symptoms (e.g., vomiting, appetite loss, and hematemesis). Considering the symptomatology and complementary tests, we decided to perform a laparoscopic hernia repair using mesh reinforcement. We provided a commented operative video to describe the surgical procedure. We then discussed the surgical technique and decided how to conduct a safe and efficient repair.
Conclusion: A surgical approach is the recommended treatment in most giant hiatal hernia due to its life-threatening complications. The technique should be tailored to the patient. Although there is no consensus whether to use a mesh reinforcement, we believed that a cautious mesh placement should be considered when the crura are of poor quality. Surgeons should also be cautious with the fundoplicature and the risk of stricture, therefore we propose the systematic use of a tube to test the passage in the esophago-gastric junction.
Keywords: Hiatal hernia, Mesh reinforcement, Repair
SUPPORTING INFORMATION
Author Contributions
Océane Wautelet - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Koenraad Van Belle - Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
François-Xavier Terryn - Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementThere is no identifiable information, the anonymity of the patient is therefore preserved.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Océane Wautelet et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
