Recurrent type IV hiatal hernia post-esophagectomy requiring hemicolectomy

Introduction: Hiatal hernia is an uncommon but potentially life-threatening complication of esophagectomies. Case Report: We report a rare case of an incarcerated type IV hiatal hernia in a patient in his mid-70s, which is a recurrence occurring one year following an Ivor–Lewis esophagectomy and repair of his first postoperative hiatal hernia. He underwent successful laparoscopic hiatal hernia repair with mesh reinforcement, along with a right hemicolectomy due to concerns of strangulated colon. We discussed the challenges in diagnosis and the considerations and controversies relevant to the surgical management of such hernias. Conclusion: There is an apparent scarcity of evidence to guide the management of these hernias. Nevertheless, a high index of suspicion and urgent surgical repair is warranted to improve patient outcomes.