부산대학교 도서관

An 82-year-old woman who had been receiving treatment with a proton pump inhibitor for reflux esophagitis was admitted to our hospital for sudden respiratory symptoms. She lapsed into shock at the outpatient department and was admitted to the intensive care unit. She was diagnosed as having acute respiratory distress syndrome due to aspiration pneumonia and received intensive treatment. After recovery, a barium swallow, upper gastrointestinal endoscopy and abdominal computed tomography revealed a type Ⅲ hiatal hernia as the presumable cause of the reflux aspiration pneumonia. Laparoscopic anti-reflux surgery was performed. The postoperative course was excellent and the patient was discharged on postoperative day 5. In Japan, laparoscopic anti-reflux surgery is not commonly performed, especially in older people and high-risk patients. However, some of these patients are good candidates for surgery because the procedure can prevent reflux and the associated complication of aspiration pneumonia. In our patient, we performed the operation soon after she recovered from pneumonia. The prompt treatment shortened her hospital stay and enabled early rehabilitation.