[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.197.75.176. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Other Articles
October 21, 1961

Symptomatic Hiatal Hernia

Author Affiliations

Veterans Administration Hospital, Durham, N.C.

JAMA. 1961;178(3):355. doi:10.1001/jama.1961.03040420095037

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

Abstract

To the Editor:—  In The Journal of July 29 (177:282, 1961) a question concerned therapy for symptomatic hiatal hernia. Dr. R. E. Braucher concisely described difficulties in diagnosis and outlined nonoperative treatment. His statements, "Only rarely should operation be necessary" and "Surgical treatment should be reserved for complications which cannot be treated medically, such as perforation or strangulation," are, in my opinion, incorrectParaesophageal hernia may be complicated by perforation or strangulation; sliding hiatal hernia is rarely. The sliding hernia is much more common by a ratio of about 20 to 1. Sliding hiatal hernia is protean in its manifestations and complications. Reflux esophagitis and not the size of the hernia is the most frequent basis for the difficulties, and this is usually corrected by operation. One of the most serious complications is a rigid stricture with shortening of the esophagus which presents a most difficult problem in treatment.

First Page Preview View Large
First page PDF preview
First page PDF preview
×