Stomach ‘stray’ on the chest of the old woman

Can ThoInstead of lying in her abdomen, the 84-year-old woman’s stomach, in Can Tho City, goes through the diaphragm gap, fully located in her chest.

Specialist specialist II La Van Phu, Head of General Surgery, Can Tho City General Hospital on October 2, said that the grandmother was admitted to the emergency hospital with severe epigastric pain, difficulty breathing and pain. chest, vomiting a lot. Family members say this has been going on for several years. The old woman often hurts after eating, taking medicine and lying down is better so her family does not go to the doctor.

The diagnostic imaging results showed that almost all of the old woman’s stomach passed through the esophageal slit, located in the mediastinum and shifted to the left. Meanwhile, the correct position of the stomach is in the abdomen, which is responsible for storing and digesting food. The stomach is in the wrong place for a long time, pressing on the heart and lungs, causing the patient to have chest pain, difficulty breathing, especially when eating full.

The doctors had an endoscopy for the elderly woman, helping to reduce the risk of complications, especially postoperative pneumonia. Image: Hospital provided.

The patient is older, so doctors decided to have laparoscopic surgery instead of open surgery, on September 29. During the operation, doctors discovered that the grandmother in addition to esophageal herniation also had two other diaphragmatic hernias, including left diaphragmatic herniation (also called Bochdalek-type diaphragmatic hernia – sticky large connective membrane) posterior diaphragmatic hernia (Morgagni-type diaphragmatic hernia).

After three hours of surgery, the ellipsis brought the stomach and the large connective membrane back to the abdomen, stitched and closed the herniated holes and created a gastroesophageal reflux valve.

Currently, the patient’s health is stable, alert, eating and drinking activities are almost normal and can be discharged in the next week.

According to Dr. PhĂș, a diaphragmatic hernia is when one or more organs in the abdominal cavity move up the thoracic cavity through any defect in the diaphragm. In children, this defect can occur at birth, called a congenital diaphragmatic hernia. Acquired diaphragmatic hernia is common in adults. Regardless of the diaphragmatic hernia, if the form is acute, the organs from the abdominal cavity run to the chest cavity, squeezing the heart, lungs, affecting breathing and circulation, all need emergency surgery to ensure life.

Doctor Phu examined patients after surgery.  Photo: Hospital provided.

Doctor Phu examined patients after surgery. Image: Hospital provided.

The grandmother is a fairly severe and rare case of diaphragmatic hernia, according to Dr. Phu. Usually, adults only have a hernia due to an injury that tears or weakens the diaphragm. Particularly this patient had three herniated holes at the same time. Bochdalek and Morgagni-type diaphragmatic hernias are congenital and are uncommon in adults.

Diaphragmatic hernias in adults are difficult to detect, the initial signs of mild hernia are shortness of breath and epigastric pain. Patients with tachycardia, including at rest, with slightly bruised skin, lip color. In the case of a large diaphragmatic herniation, the organs from the abdomen overflow into the chest, the patient has severe difficulty breathing, sometimes respiratory failure and death.

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