Hernia hiatal mixta con vólvulo gástrico intratorácico: reporte de caso y revisión de la literatura

Ricardo Villarreal, Felipe Bernal, Luis Felipe Cabrera, Sebastián Sánchez Ussa, Mauricio Pedraza

Resumen


Introducción: El estómago intratorácico volvulado (EIV) es un tipo de hernia hiatal caracterizada por la presencia de una gran porción gástrica en el mediastino. Patología de gran importancia ya que de no operarse oportunamente puede conllevar un mal pronóstico.
Caso clínico: Paciente femenina de 56 años con epigastralgia aguda e intolerancia a la vía oral asociada a náuseas y múltiples episodios eméticos de contenido alimentario. Sin antecedentes médicos o quirúrgicos relevantes, endoscopia de vías digestivas altas y una radiografía de tórax en donde reportan un posible vólvulo gástrico con un ensanchamiento del mediastino inferior y presencia de la cámara gástrica a nivel del tórax.
Discusión: Debido a que un estómago herniado volvulado a nivel del tórax presenta un alto riesgo de complicaciones, está, en estos infrecuentes casos, indicada la cirugía de urgencia. En pacientes clínicamente estables con una evolución reciente de obstrucción gástrica se sugiere el abordaje laparoscópico para su reducción y reparación de la hernia. Sin embargo, en casos de pacientes inestables, la reparación abierta es el método quirúrgico de elección.


Palabras clave


Estómago al revés, hernia hiatal, Hernia paraesofágica, Incarceración gástrica, Obstrucción gástrica, Vólvulo gástrico.

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Referencias


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DOI: http://dx.doi.org/10.20960/rhh.140

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