During the past 5 years we operated 13 cases of combination of a hiatal hernia and a transpyloric prolapse of the gastric mucosa. These represent ca. 7% of all operated hiatal herniae. In addition we treated 9 cases conservatively, at that the combination of a loose cardia and a labile pylorus was diagnosed through endoscope. Results of these both treatments are satisfactory. 12% of operated hiatal herniae are combined with duodenal ulcer but only 4% with gastric ulcer. It may be concluded that gastric entrance (cardia) and exit (pylorus) have a close connection.

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