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December 1958

Esophageal Hiatus Hernia with Obstructive Incarceration of Pylorus, Pancreas, and Duodenum

Author Affiliations

From the Surgical Service, Ball Memorial Hospital, Muncie, Ind., and the Department of Surgery, Indiana University School of Medicine.

AMA Arch Surg. 1958;77(6):997-999. doi:10.1001/archsurg.1958.01290050167031

Symptoms associated with the presence of esophageal hiatus hernia of the diaphragm may vary widely. Often the herniation may produce no symptoms. In other cases the symptoms may be vague ones of indigestion with occasional vomiting. At times, symptoms attributed to the demonstrated presence of an esophageal hiatus hernia may in fact be due to accompanying pathology, such as occlusive coronary artery disease, peptic ulceration of the stomach or duodenum, gallstones, and pancreatitis. Severe episodes of vomiting may be encountered in some cases. Sweet,5 in 1952, reported the occurrence of obstruction, with intermittent or unrelieved vomiting, in 13 of 111 patients. Incarceration of abdominal viscera with strangulation and gangrene rarely occurs in this type of hernia. The strangulating type of obstruction with gangrene generally is found in the post-traumatic type of diaphragmatic hernia.1,3

The major types of esophageal hiatus hernia are the sliding type, in which there is