Acute hiatal hernia with oesophageal perforation following Heller's operation

Abstract

Abstract The unusual complication of acute hiatal hernia with oesophageal rupture following transthoracic oesophagomyotomy is described in 2 cases. Inadvertent disruption and sidening of the oesophageal hiatus at the time of surgery coupled with increased intragastric and intraabdominal pressure were the probable causes. The hiatus should be carefully inspected on completion of the myotomy and anatomical restoration performed if necessary in order to avoid this complication. Urgent surgical intervention, gastric fundal serosal patch repair and intravenous alimentation proved successful in the management of these patients.