Postesophagectomy diaphragmatic hernia

A 77-year-old male patient with a history of total esophagectomy in three fields came to the emergency department due to sudden abdominal pain and vomiting. He presented with pain in the epigastrium and hypoventilation of the right hemithorax. Computed tomography scan revealed posterior diaphragmatic hernia with signs of intestinal obstruction and incipient intestinal distress (Fig. 1). We decided to perform urgent laparotomy to reduce the hernia from the abdomen, without the need for intestinal resection due to the viability of the intestine (Fig. 2). Afterwards, we conducted tension-free closure of the crura of the diaphragm using non-absorbable suture. The postoperative patient evolution was satisfactory, and follow-up imaging studies 8 months later detected no hernia recurrence.

Figure 1

Figure 2

Diagnosis

Post-esophagectomy diaphragmatic hernia.