title: Traumatic right paraesophageal hernia after Belsey Mark IV fundoplication.
abstract: We report the case of a 70-year-old woman with a long history of achalasia and gastroesophageal reflux disease who presented with an acute right-sided paraesophageal hernia after a motor vehicle accident. Six months before the accident, she underwent an elective Belsey Mark IV fundoplication to reduce a hiatal hernia. The traumatic paraesophageal hernia traversed the diaphragm at a weakness opposite the fundoplication. The clinical presentation, surgical management, and previous literature are discussed.
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Johns Hopkins Medical Institution, Baltimore, Maryland, USA. durr@jhmi.edu
authors.forename: Megan L
authors.initials: ML
authors.lastname: Durr
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Yang
mesh_terms: D000063:Accidents, Traffic; D000368:Aged; D004638:Emergency Treatment; D004931:Esophageal Achalasia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006551:Hernia, Hiatal / Q000150:complications / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy / Q000379:methods; D018570:Risk Assessment; D013270:Stomach / Q000293:injuries*; D016896:Treatment Outcome