Yasheng D, Wulamu W, Li YL, Tuhongjiang A, Abudureyimu K. Laparoscopic repair of complete intrathoracic stomach with iron deficiency anemia: A case report. World J Clin Cases 2020; 8(6): 1180-1187 [PMID: 32258090 DOI: 10.12998/wjcc.v8.i6.1180]
Corresponding Author of This Article
Kelimu Abudureyimu, MD, Chief Doctor, Executive Vice President, Professor, General Surgeon, Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. klm6075@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Duolikun Yasheng, Yi-Liang Li, Airexiati Tuhongjiang, Kelimu Abudureyimu, Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Wubulikasimu Wulamu, Department of Gastrointestinal Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Author contributions: Yasheng D and Li YL were the surgeons in charge of the patient, reviewed the literature and interpreted the imaging findings; Wulamu W reviewed the literature and was mainly responsible for writing and revising the manuscript; Tuhongjiang A reviewed the literature and collected the data; Abudureyimu K, Yasheng D and Li YL performed the surgery; Abudureyimu K was responsible for the supervision and revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Kelimu Abudureyimu, MD, Chief Doctor, Executive Vice President, Professor, General Surgeon, Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. klm6075@163.com
Received: December 17, 2019 Peer-review started: December 17, 2019 First decision: January 13, 2020 Revised: February 10, 2020 Accepted: March 5, 2020 Article in press: March 5, 2020 Published online: March 26, 2020 Processing time: 99 Days and 11.5 Hours
Abstract
BACKGROUND
Giant paraesophageal hiatal hernias (HH) are very infrequent, and their spectrum of clinical manifestations is large. Giant HH mainly occurs in elderly patients, and its relationship with anemia has been reported. For the surgical treatment of large HH, Nissen fundoplication is the most common antireflux procedure, and the reinforcement of HH repair with a patch (either synthetic or biologic) is still debatable.
CASE SUMMARY
We report on a case of giant paraesophageal HH in a middle-aged male patient with reflux symptoms and severe anemia. After performing a series of tests and diagnostic approaches, results showed a complete intrathoracic stomach associated with severe iron deficiency anemia. The patient underwent successful laparoscopic hernia repair with mesh reinforcement and Nissen fundoplication. Postoperatively, reflux symptoms were markedly relieved, and the imaging study showed complete reduction of the hernia sac. More importantly, anemia was resolved, and hemoglobin, serum iron and ferritin level were returned to the normal range. The patient kept regular follow-up appointments and remained in a satisfactory condition.
CONCLUSION
This case report highlights the relationship between large HH and iron deficiency anemia. For the surgical treatment of large HH, laparoscopic repair of large HH combined with antireflux procedure and mesh reinforcement is recommended.
Core tip: Giant paraesophageal hiatal hernia (HH) usually occurs in elderly patients and is relatively rare. We present a case of complete intrathoracic stomach in a 46-year-old male with reflux symptoms and severe iron deficiency anemia. The patient underwent successful laparoscopic hernia repair with mesh reinforcement and Nissen fundoplication. Postoperatively, reflux symptoms and iron deficiency anemia were resolved. The patient remained in a satisfactory condition. This case highlights that large HH is a potential cause of iron deficiency anemia. For the surgical treatment of large HH, laparoscopic repair of large HH combined with antireflux procedure and mesh reinforcement is recommended.
