title: Hiatus Hernia: A Rare Cause of Acute Pancreatitis.
abstract: Hiatal hernia (HH) is the herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm. A giant HH with pancreatic prolapse is very rare and its causing pancreatitis is an even more extraordinary condition. We describe a case of a 65-year-old man diagnosed with acute pancreatitis secondary to pancreatic herniation. In these cases, acute pancreatitis may be caused by the diaphragmatic crura impinging upon the pancreas and leading to repetitive trauma as it crosses the hernia; intermittent folding of the main pancreatic duct; ischemia associated with stretching at its vascular pedicle; or total pancreatic incarceration. Asymptomatic hernia may not require any treatment, while multiple studies have supported the recommendation of early elective repair as a safer route in symptomatic patients. In summary, though rare, pancreatic herniation should be considered as a cause of acute pancreatitis. A high index of suspicion for complications is warranted in cases like these.
authors.affiliation: Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Shruti
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Ghulamullah
authors.identifier: 0000-0002-9195-7232
authors.initials: G
authors.lastname: Shahzad
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Mahreema
authors.initials: M
authors.lastname: Jawairia
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Krishnaiyer
authors.initials: K
authors.lastname: Subramani
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Prakash
authors.identifier: 0000-0003-1309-2197
authors.initials: P
authors.lastname: Viswanathan
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Mustacchia