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Incarcerated paraoesophageal hernia complicated with distal oesophageal perforation: a combined laparoscopic and endoscopic approach
  1. Tiago Correia de Sá1,
  2. Jorge Silva2 and
  3. Carla Freitas3
  1. 1General Surgery, Centro Hospitalar Tamega e Sousa EPE, Guilhufe, Portugal
  2. 2Gastroenterology Department, Centro Hospitalar Tamega e Sousa EPE, Guilhufe, Portugal
  3. 3General Surgery, Esophagogastric Surgery Unit, Centro Hospitalar Tamega e Sousa EPE, Guilhufe, Portugal
  1. Correspondence to Dr Tiago Correia de Sá;{at}


Paraoesophageal hernias are common, but symptoms are not always present nor pathognomonic of this condition, and patients may be suffering for many years before a diagnosis is made. Incarceration and strangulation are rare, but they are life-threatening complications, warranting an emergent surgical repair. Hiatal hernia incarceration causing distal oesophagus perforation is even rarer. To our knowledge, this is the first case report in adult patients. Despite many advances in care, a high grade of suspicion is needed to diagnose this condition, and the mortality rate for an oesophageal perforation remains high, achieving 50% in some series. We present the surgical management of a case of hiatal hernia incarceration with distal oesophagus perforation by combined laparoscopy and upper endoscopy.

  • gastrointestinal surgery
  • GI-stents
  • endoscopy

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  • Contributors We would like to herein confirm that all authors have contributed to the manuscript, as stated. TCdS, JS and CF were actively involved in the diagnosis, treatment and follow-up of the patient and helped in planning. TCdS reviewed the patient’s clinical files and wrote the case report. CF and JS reviewed the manuscript. In the end, the manuscript was approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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