Clinical experience has shown that esophageal hiatus hernia in older persons often presents diagnostic and therapeutic problems. The reasons for this are that the hiatus hernia may exist without symptoms; it may produce a syndrome which simulates other diseases, as for example, cholelithiasis or cardiovascular disease; it may be associated with other diseases and produce complications, the symptoms of which dominate the clinical picture, and, finally, the treatment of hiatus hernia, whether medical or surgical, is not infrequently followed by a recurrence of the symptoms. In this article we wish to stress two aspects of this subject, namely, varied clinical manifestations of associated diseases of hiatus hernia which were encountered in a group of patients and the surgical treatment by phrenic interruption. r
This study is based on a series of 29 patients whose age range was from 50 to 86 years. Seven were men; 22 were women.
PICKHARDT OC, RAFSKY HA, GHISELIN FH. TREATMENT OF HIATUS HERNIA IN OLDER PERSONS. JAMA. 1950;142(5):310-315. doi:10.1001/jama.1950.02910230012003