Department of Clinical Surgical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad, West Indies.
Hernia. 2013 Apr;17(2):275-7. doi: 10.1007/s10029-011-0844-7. Epub 2011 Jun 26.
The first patient with strangulated hiatus hernia due to pyloric stenosis is reported. A 70-year-old male patient presented as an emergency with severe left-sided chest pain, tachycardia, tachypnea, dysphagia, and nausea but no vomiting. The diagnosis of strangulated hiatus hernia due to pyloric stenosis was suspected, because a CT scan done 24 h following a barium meal showed much retained barium in both infra- and supradiaphragmatic parts of the stomach. Recognition of this condition is important since absence of pneumoperitoneum should not delay the diagnosis. In this complication, the perforation is likely to be at the hiatus, not the fundus as occurs in other causes of strangulation. A gastric drainage procedure should be an essential part of treatment.
首例因幽门狭窄导致绞窄性食管裂孔疝的患者报告如下。一名 70 岁男性患者因剧烈左侧胸痛、心动过速、呼吸急促、吞咽困难和恶心但无呕吐而急诊就诊。由于钡餐检查后 24 小时进行的 CT 扫描显示胃的膈下和膈上部分均有大量钡剂残留，故怀疑诊断为幽门狭窄所致的绞窄性食管裂孔疝。由于这种情况中穿孔很可能发生在裂孔而不是像其他绞窄原因那样发生在胃底部，因此认识到这种情况很重要。胃引流术应成为治疗的重要组成部分。
