A gastric hiatal hernia may make abdominal pain disappear.
Recurrent abdominal pain developed in a 74-year-old woman that chronically suffered from retrosternal pain and regurgitation. An erect abdominal plain film showed a fluid level in the ascending colon and an enlargement of the posterior lower mediastinum containing gas on the right. Unexpectedly, the patient reported that abdominal pain disappeared after meals. Double contrast enema and contemporaneous barium swallow showed herniation of the left colonic flexure into the left lower mediastinum and a gastric hernia within the right lower mediastinum, respectively. The hernias were in the same site of the enlargement of the mediastinum seen on the plain abdominal film. The colonic hernia partially reduced when the gastric hernia was filled with barium. We postulate that these findings could explain the disappearance of the colic obstruction and abdominal pain after meals.
Pomerri
Fabio
F
Department of Medical Diagnostic Sciences and Special Therapies, Padua University Hospital, via Giustiniani 2, 35128 Padua, Italy. fabio.pomerri@rad.unipd.it
Bilora
Franca
F
Muzzio
Pier Carlo
PC
D015746:Abdominal Pain / Q000503:physiopathology*; D000368:Aged; D003108:Colonic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006547:Hernia / Q000150:complications / Q000000981:diagnostic imaging*; D006551:Hernia, Hiatal / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D011859:Radiography