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{'症例は71歳,男性.2011年10月に食道癌(Mt)に対して,右開胸開腹食道亜全摘術,後縦隔経路胃管再建を施行した.2012年7月,嘔吐あり来院.CTで左胸腔内へ腸管迷入を認め,横隔膜ヘルニアによるイレウスと診断し緊急手術を施行した.食道裂孔開大部をヘルニア門とし小腸が左胸腔内に迷入し全長にわたり壊死をきたしていた.約260cmの小腸切除と食道裂孔縫合閉鎖を行った.2013年1月,再度嘔気が出現.胸部X線にて左胸腔内に腸管ガス像を認め横隔膜ヘルニアの再発として緊急手術を施行した.前回縫合閉鎖した食道裂孔は全く組織癒合しておらず,左胸腔内に横行結腸が迷入していた.腸管壊死所見は無く食道裂孔を非吸収糸で閉鎖し,さらに大網で被覆した.食道癌術後の横隔膜ヘルニアは頻度は稀であるが診断が遅れると腸管壊死をきたす重大な合併症であるが,本症例はさらに再発をきたした.原因も含め文献的考察を加え報告する.': [0]}, 'cited_by_api_url': 'https://api.openalex.org/works?filter=cites:W2316560788', 'counts_by_year': [{'year': 2023, 'cited_by_count': 1}, {'year': 2020, 'cited_by_count': 1}, {'year': 2017, 'cited_by_count': 1}, {'year': 2016, 'cited_by_count': 1}], 'updated_date': '2024-09-19T23:43:13.034579', 'created_date': '2016-06-24'}