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Case 166: Chest Pain

This 49 year old lady has had a laparoscopic anti-reflux operation two years previously. She now presents with trouble swallowing and retrosternal chest pain.

1. What does the xray show?

This a barium swallow, and it demonstrates a paraoesophageal hernia, with a moderate sized portion of the proximal stomach herniating into the chest.

2. What are the options for management?

This problem, when symptomatic requires operative repair. This may be possible laparoscopically, or require open repair. The principles are reduction of the hernia, anatomical hiatal repair, and redo fundoplication.

PubMed - Laparoscopic repair of giant paraesophageal hernia: 100 consecutive cases.