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April 1962

Treatment of Esophageal Hiatal Hernia: A Physiologic Operation Including Hernia Repair, Vagotomy, and Pyloroplasty

Author Affiliations

From the Edwards-Eve Clinic, the Surgical Service of St. Thomas Hospital, and the Department of Surgery, Vanderbilt University School of Medicine.

Arch Surg. 1962;84(4):379-389. doi:10.1001/archsurg.1962.01300220003001

Esophageal hiatal hernia is now being accorded its rightful importance as a frequent cause of lower thoracic and upper abdominal complaints. Prior to 20 years ago, the roentgen demonstration of an esophageal hiatal hernia was looked upon as a medical curiosity. It is now well established that the symptomatology produced by the herniation may at times mimic that of cardiac disorders, biliary colic, duodenal ulcer, or even pulmonary disease. Many patients have been treated for the above-named disorders for varying periods of time before the correct diagnosis was arrived at. Internists are becoming more aware of the symptomatology produced by hiatal hernia, and an increasing number of patients are being referred for surgical correction of the anatomic defect. Also, the results following surgical repair have improved over the past decade due to a better understanding of the anatomic and physiologic derangements produced by the herniation. However, in spite of the

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