An Unusual Cause of Abdominal Pain in an Elderly Woman

Lal, Anupam; Gupta, Pankaj; Sinha, Saroj Kant

doi:10.1053/j.gastro.2014.11.036

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…peripancreatic fat stranding or fluid collection). Of note, five patients had the clinical features of both types 2 and 3 (8,(15)(16)(17)(18). Since our case showed abnormal liver function tests and definite dilation of the bile duct, we categorized this patient as having type 2.…”

Section: Discussionmentioning

confidence: 95%

Hiatal Hernia with Prolapse of the Pancreas Causing Bile Duct Stricture and Liver Function Disorders: A Case Report and Literature Review

et al. 2023

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Hiatal hernia is a common condition in elderly patients, but the additional presence of prolapse of the pancreas is extremely rare. We herein report an 89-year-old woman who presented with liver function disorders and abdominal pain. Her laboratory tests revealed cholestasis, and imaging examinations showed stenosis of the common bile duct pulled toward the hernia sac. She was diagnosed with a common bile duct stricture due to pancreatic herniation and underwent laparoscopic surgery. Our review of the literature identified three types of pancreatic herniations: asymptomatic, bile duct complication, and acute pancreatitis. Pancreatic head herniation tends to induce bile duct complications.

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Section: Discussionmentioning

confidence: 95%

Hiatal Hernia with Prolapse of the Pancreas Causing Bile Duct Stricture and Liver Function Disorders: A Case Report and Literature Review

et al. 2023

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“…En la mayoría de estos, es el cuerpo y la cola los que migran a través del diafragma, siendo la herniación de la cabeza pancreática un proceso extremadamente raro. Una revisión sistemática de los casos de páncreas herniados a través del hiato esofágico reportados desde 1958 hasta 2020, identifica tan solo 17 pacientes diagnosticados de pancreatitis aguda secundaria a hernias paraesofágicas tipo IV [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] (Tabla 1).…”

Section: Discussionunclassified

“…La HH tipo IV es aquella en la que junto al estómago se produce la herniación de otros órganos abdominales. Es poco frecuente, representando el 5-7 % de todas las HH paraesofágicas, siendo colon, intestino delgado, epiplón y bazo los órganos más comúnmente herniados 3 .…”

Section: Introductionunclassified

Pancreatitis aguda necrosante secundaria a hernia de hiato grado IV complicada: Presentación de un caso y revisión de la literatura

et al. 2021

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Introducción. En las hernias paraesofágicas tipo IV se produce la herniación del estómago junto a otros órganos abdominales. La herniación del páncreas es muy infrecuente. Caso clínico. Varón de 57 años que acude por dolor torácico, disnea e intolerancia al decúbito. En la tomografía computarizada toracoabdominal se observa hernia diafragmática que contiene colon transverso, intestino delgado y páncreas, con reticulación de la grasa alrededor del mismo, compatible con pancreatitis aguda. Conclusión. La asociación de hernia hiatal con páncreas herniado y pancreatitis es extremadamente infrecuente. El diagnóstico se estableció mediante tomografía computarizada y el tratamiento fue conservador, con cirugía diferida de la hernia de hiato.

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“…Herniation of pancreas can be without symptoms and found accidentally on imaging or as a sequel to acute pancreatitis. Acute pancreatitis as a sequela of this mechanism is very rare and has been previously reported in 13 patients [13][14][15][16][17][18][19][20][21][22][23][24][25]. Table 1 lists acute pancreatitis caused by the herniation of pancreas in HH from previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…Cases of pancreatic herniation with pancreatitis are rare; therefore, the ideal treatment is still unclear [20,21]. Some HH cases with pancreatitis were treated with surgery in the past [13,14,17,24], but in other cases, physicians chose conservative treatment including administration of intravenous fluids, pain killers, and diet as tolerated because of high risk of surgery [15,16] or patient's refusal to undergo operation [16,[18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

2020

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Background: Hiatal hernia is defined by the permanent or intermittent prolapse of any abdominal structure into the chest through the diaphragmatic esophageal hiatus. Prolapse of the stomach, intestine, transverse colon, and spleen is relatively common, but herniation of the pancreas is a rare condition. We describe a case of acute pancreatitis and bile duct dilatation secondary to a massive hiatal hernia of pancreatic body and tail. Case presentation: An 86-year-old woman with hiatal hernia who complained of epigastric pain and vomiting was admitted to our hospital. Blood tests revealed a hyperamylasemia and abnormal liver function test. Computed tomography revealed prolapse of the massive hiatal hernia, containing the stomach and pancreatic body and tail, with peripancreatic fluid in the posterior mediastinal space as a sequel to pancreatitis. In addition, intrahepatic and extrahepatic bile ducts were seen to be dilated and deformed. After conservative treatment for pancreatitis, an elective operation was performed. There was a strong adhesion between the hernial sac and the right diaphragmatic crus. After the stomach and pancreas were pulled into the abdominal cavity, the hiatal orifice was closed by silk thread sutures (primary repair), and the mesh was fixed in front of the hernial orifice. Toupet fundoplication and intraoperative endoscopy were performed. The patient had an uneventful postoperative course post-procedure. Conclusion: A rare massive hiatal hernia, involving the stomach and pancreatic body and tail, can cause acute pancreatitis with bile duct dilatation. The etiology can be flexure of the main pancreatic and extrahepatic bile ducts. Symptomatic herniation is best treated with surgery. Elective surgery is thought to be safer than emergent surgery in patients with serious complications.

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An Unusual Cause of Abdominal Pain in an Elderly Woman

Cited by 4 publications

References 2 publications

Hiatal Hernia with Prolapse of the Pancreas Causing Bile Duct Stricture and Liver Function Disorders: A Case Report and Literature Review

Hiatal Hernia with Prolapse of the Pancreas Causing Bile Duct Stricture and Liver Function Disorders: A Case Report and Literature Review

Pancreatitis aguda necrosante secundaria a hernia de hiato grado IV complicada: Presentación de un caso y revisión de la literatura

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

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