ESOPHAGEAL HIATUS HERNIA WITH GASTRIC CANCER AT THE HERNIATED PORTION -REPORT OF TWO CASES-

Abstract

Cinical cases of esophageal hiatus hernia with gastric cancer are rare and have numbered only ten in Japan so far. This paper presents our experience with two cases of the disease. Case 1: A 74-year-old man was seen at the hospital because of epigastric pain. Upper gastrointestinal series revealed a sliding hiatus hernia of the esophagus, and an upper endoscopy showed a IIc leion at the herniated portion. Upper abdominal midline incision, proximal gastrectomy, D1 dissection, and jejunal interposition were performed. Histopathologically the lesion was differentiated tubular adenocarcinoma with invasion depth of m and without any lymph node metastasis. There have been no signs of recurrence, as of 5 years after the operation. Case 2: an 83-year-old woman was seen at the hospital because of dysphagia. Upper gastrointestinal series and upper endoscopy revealed a mixed type of esophageal hiatus hernia and a Borrmann type 2 lesion at the cardiac part of the stomach. An open-heart surgery between 7th lib, proximal gastrectomy, D1 dissection, and esophagogastric anastomosis were performed. Histopathologically, it was poorly differentiated adenocarcinoma with the invasion depth of mp and without lymph node metastasis. As of one year after the operation, the patient is followed on an ambulant basis.