Acute appendicitis with large complex para-oesophageal hiatus hernia

Case contributed by Dr David Tunchon

Presentation

Patient presented with acute abdominal pain localised to the right iliac fossa, anorexia and a raised C-reactive protein.

Patient Data

Age: 55
Gender: Female

Appendix was noted to have a thickened wall that was hyperaemic in keeping with acute appendicitis. Incidental finding of a large para-oesophageal hiatus hernia containing the entire stomach and the majority of the transverse colon.

Case Discussion

The patient underwent routine emergency laparoscopic appendicectomy without complication. With regard to the large para-oesophageal hernia, the patient was completely unaware of this prominent incidental finding. In retrospect, the patient felt she had become increasingly short of breath over a period of 12 months. On review of imaging by a general surgeon it was thought that the finding was likely of longstanding and that surgical repair would be difficult.

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Case information

rID: 54704
Case created: 24th Jul 2017
Last edited: 31st Jul 2017
Inclusion in quiz mode: Included

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