title: Strangulated perforated hiatus hernia due to pyloric stenosis.
abstract: 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.
authors.affiliation: Department of Clinical Surgical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad, West Indies.
authors.forename: Vijay
authors.initials: V
authors.lastname: Naraynsingh
authors.forename: Ravi
authors.initials: R
authors.lastname: Maharaj
authors.forename: Dilip
authors.initials: D
authors.lastname: Dan
authors.forename: Seetharaman
authors.initials: S
authors.lastname: Hariharan
mesh_terms: D000368:Aged; D006551:Hernia, Hiatal / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D011707:Pyloric Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed