title: Gastric necrosis secondary to strangulated giant paraesophic hiatal hernia.
abstract: Asymptomatic giant hiatal hernia comprises a relatively common disease, mostly presented in women with 50 years onwards. The therapeutic approach remains controversial in recent years. Under the latest SAGES`revision, all the symptomatic hernias must be repaired, but the symptomatic hiatal hernia definition isn`t even now established. We present the case os a A 67 - year old woman with an asymptomatic hiatal hernia, that is admitted to our hospital owing to toracic and abdominal pain. This pain was related with food intake for 6 months. The patient presents a clear worsening in the last 24 hours, with no other asociated symptomatology. Suspecting an incarcerated hiatal hernia with stomach perforation, the patient is taken to theatre for a laparotomy during the early hours. An atypic gastrectomy of the greater curvature with a gastropexy is performed with fixation to the anterior abdominal wall. The surgery is completed with a feeding jejunostomy. The Manegement of giant paraesophagic hernias, still remains as one of the challenge of the esophageal surgeons.
authors.affiliation: Cirugia General y del Aparato Digestivo, Hospital Doctor Peset, España.
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Díez Ares
authors.affiliation: Cirugía General y Digestiva, Hospital Doctor Peset. Valencia.
authors.forename: Nuria
authors.initials: N
authors.lastname: Peris Tomás
authors.affiliation: Cirugía General y Digestiva, Hospital Doctor Peset. Valencia.
authors.forename: Nuria
authors.initials: N
authors.lastname: Estellés Vidagany
authors.affiliation: Cirugía General y Digestiva, Hospital Doctor Peset. Valencia.
authors.forename: Dolores
authors.initials: D
authors.lastname: Periáñez Gómez
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005743:Gastrectomy; D006551:Hernia, Hiatal / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D009336:Necrosis; D009767:Obesity, Morbid / Q000150:complications; D013270:Stomach / Q000473:pathology; D013272:Stomach Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed