Incarceration of gastric fundus in a paraesophageal hernia after gastroplasty.

A tension hydropneumothorax developed suddenly in a 33-year-old woman, 5 days after gastroplasty. The cause was not immediately apparent. Radiologic investigation demonstrated incarceration of the fundus of the stomach together with the stapled pouch in a paraesophageal hernia. Abdominal exploration revealed a blow-out in the wall of the incarcerated fundus. After appropriate repair and management, the patient's course was uncomplicated. This case highlights the need for repairing paraesophageal hernias as soon as they are discovered, particularly during operations that require mobilization of the esophagus and cardia, as in gastroplasty.