Diaphragmatic Hernia After Ivor-Lewis Esophagectomy: A Case Report and Literature Review

The study is aimed at examining the current literature on the surgical management and outcomes associated with post-operative hiatal hernia and at presenting a case of post-operative hiatal hernia after Ivor-Lewis esophagectomy, to enrich our knowledge on this specific field. A 57-year-old man who underwent neoadjuvant RT-CT and subsequent Ivor-Lewis esophagectomy underwent urgent laparotomy. The operation revealed a strangulated necrotic small bowel inside the diaphragmatic hernia sac and part of the descending colon without ischemia. A total of 40 cm of small bowel was removed. The diaphragmatic defect was repaired with interrupted sutures. The immediate postoperative course was uneventful. Post-operative hiatal hernia is a major surgical complication after Ivor-Lewis esophagectomy due to esophageal cancer, requiring surgical repair. Despite advancements in surgical techniques, diaphragmatic hernia remains a challenging postoperative issue. Since surgery is the only available approach for the treatment of diaphragmatic hernia containing a strangulated abdominal organ, early diagnosis is crucial. Due to a high rate of emergency surgery with life-threatening complications, early surgical repair may be indicated rather than watchful waiting.