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http://dx.doi.org/10.1259/0007-1285-39-465-703DOI Listing

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Hiatal hernias occur when abdominal contents protrude into the posterior mediastinum through the esophageal hiatus of the diaphragm. They are classified into four types, with Type I (sliding) being the most prevalent. We report a case of a patient diagnosed with a large Type IV paraesophageal hernia.

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Article Synopsis
  • - A sliding hiatal hernia is common, especially in older adults, but its incarceration is rare and requires urgent surgery if it occurs.
  • - A case involving a 95-year-old woman showed she had a giant sliding incarcerated hiatal hernia causing thoracic pain, which was diagnosed using X-ray and CT scans.
  • - After confirming the hernia strangulation, surgeons performed a successful laparotomy and Nissen fundoplication, allowing the patient to recover well despite the complexities of surgery in elderly patients.
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  • * Diagnosis is confirmed through imaging techniques like gastrografin and CT scans, revealing issues such as GERD, hiatal hernias, and altered anatomy post-surgery.
  • * Treatment often involves converting to Roux-en-Y bypass, but other options like laparoscopic hiatal hernia repair are also effective, with patients showing stability and no complications post-surgery.
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