ABSTRACT

We report herein the case of a four-year-old boy with paraesophageal hiatal hernia who presented with shock. A laparotomy revealed that the stomach had prolapsed totally through the paraesophageal hiatal defect into the right chest, and had become volvulized and strangulated. The stomach had been dilated enormously by undigested sunfl ower seeds, resulting in ischemia and perforation of the gastroesophageal junction. Subtotal gastric resection and transthoracic esophagogastric anastomosis were performed. In this report, the pathogenesis of esophageal perforation and the surgical approach are discussed.