Ferrer Ocampo Lovingly M, Lin Jennifer, Donnatien Leah, Singh Gurpreet, Lincer Robert
Biomedical Sciences, Touro College of Osteopathic Medicine, Middletown, USA.
General Surgery, Garnet Health Medical Center, Middletown, USA.
Cureus. 2024 Jul 1;16(7):e63595. doi: 10.7759/cureus.63595. eCollection 2024 Jul.
Hiatal hernias occur when intra-abdominal contents protrude into the diaphragmatic opening. Of the four classifications, Type 4 hiatal hernias are the most rare and severe. They develop from herniation of the gastroesophageal junction and abdominal viscera other than the stomach into the thoracic cavity. The resulting increase in intrathoracic pressure can cause a wide variety of symptoms on presentation and potentially lead to misdiagnosis. We present a rare case in which a 78-year-old woman presented with nonspecific symptoms and was diagnosed with incarcerated Type 4 hiatal hernia with sigmoid volvulus. We also report a literature review from 2015 to emphasize the importance of recognizing diverse symptomatic presentations in complex Type 4 hiatal hernias and the need for a comprehensive evaluation, as early detection and prompt intervention are essential in preventing life-threatening complications.
当腹腔内容物突出进入膈裂孔时，就会发生食管裂孔疝。在四种分类中，4型食管裂孔疝最为罕见且严重。它们由胃食管交界处和除胃以外的腹腔内脏器疝入胸腔发展而来。由此导致的胸内压升高可在发病时引起各种各样的症状，并可能导致误诊。我们报告一例罕见病例，一名78岁女性出现非特异性症状，被诊断为伴有乙状结肠扭转的绞窄性4型食管裂孔疝。我们还报告了一项2015年以来的文献综述，以强调认识复杂4型食管裂孔疝各种症状表现的重要性以及进行全面评估的必要性，因为早期发现和及时干预对于预防危及生命的并发症至关重要。
