Giant Hiatal Hernia with Biliopancreatic Duct Dilatation

Abstract

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Acute pancreatitis associated with massive paraesophageal hernia involving the presence of the pancreatic body and tail

“…Complications such as volvulus, occlusion, ischemia, or even perforation can, however, occur. 8,11 Some cases of this rare cause of acute pancreatitis have been reported in literature in the past. [12][13][14][15][16][17][18][19][20][21][22][23][24] Migration of pancreas in the thorax has been also reported not associated with acute pancreatitis [25][26][27][28][29] or with symptoms of mechanical cholestasis such as mild jaundice, pruritus, diarrhea and fatigue.…”

Acute Pancreatitis Secondary to an Incarcerated Paraoesophageal Hernia: A Rare Cause for a Common Problem

“…[7][8] Standard preoperative investigations include CT scan chest/abdomen, upper gastrointestinal contrast study, and upper gastrointestinal endoscopy. 9,10 Previously published cases of pancreatic herniation through the diaphragm [3][4][5][6][7]11,12 include four cases associated with pancreatitis, [3][4][5][6] two of which were in cases of congenital diaphragmatic herniae. 4,6 The causal elements of acute pancreatitis in such a herniation have been postulated as repetitive trauma associated with pancreatic movement across the hernia, ischemic compromise of the vascular pedicle, or intermittent folding of the main pancreatic duct.…”

“…Herniation of the pancreas through the diaphragm without complicating pancreatitis is described. 7 , 11 , 12 The case presented here offers an evaluation of the inflamed pancreas with magnetic resonance imaging, including MRCP. Computed tomography and magnetic resonance imaging both offer evaluation of the pancreatic parenchyma and adjacent soft tissues; however, magnetic resonance imaging allows multiplanar imaging, and MRCP offers a unique non-invasive opportunity to investigate the pancreatic and biliary ducts in these rare patients.…”