{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:31:39Z","timestamp":1772987499253,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":319,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>An 86\u2010year\u2010old woman presented with repeated vomiting and hematemesis. Imaging revealed extensive mediastinal food debris accumulation, diagnosing spontaneous esophageal perforation. CT showed debris predominantly in the anterior\u2010right mediastinum around the esophagogastric junction, with minimal bilateral pleural effusion. Upper gastrointestinal contrast study demonstrated luminal contrast extravasation without thoracic or abdominal extension. Additional history from family members revealed that the patient had been previously diagnosed with a hiatal hernia by a physician. Given stable conditions, we hypothesized that the perforation was contained within the hernia sac and selected a transhiatal approach. Intraoperatively, an approximately 5\u2010cm longitudinal tear across the esophagogastric junction was identified and successfully repaired with drainage utilizing the hiatal hernia space. Unlike typical esophageal perforation progressing to severe left\u2010sided empyema, this case's hiatal hernia created lax esophageal adventitia, distributing pressure into the hernia sac and preventing thoracic or abdominal perforation.<\/jats:p>","DOI":"10.1111\/ases.70188","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:18:52Z","timestamp":1763338732000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful Transhiatal Repair of Spontaneous Esophagogastric Junction Perforation Contained Within a Hiatal Hernia Sac: A Case Report"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7029-5448","authenticated-orcid":false,"given":"Eiichiro","family":"Nakao","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4694-3413","authenticated-orcid":false,"given":"Yasunori","family":"Kurahashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6535-2071","authenticated-orcid":false,"given":"Motoki","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0771-1721","authenticated-orcid":false,"given":"Shugo","family":"Kohno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4484-2926","authenticated-orcid":false,"given":"Yudai","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8063-9319","authenticated-orcid":false,"given":"Tatsuro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4122-3799","authenticated-orcid":false,"given":"Yoshinori","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1397-8046","authenticated-orcid":false,"given":"Hisashi","family":"Shinohara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hyogo Medical University  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-19-66"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.08.037"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02385268"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-06863-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.06.058"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-023-01023-x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2022.107484"},{"key":"e_1_2_9_9_1","first-page":"1294","article-title":"Boerhaave's Syndrome With Paraesophageal Hiatus Hernia","volume":"80","author":"Hines G. 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