title: Hiatal Hernia as the Cause of G-Induced Abdominal Pain.
abstract: Sliding hiatal hernias are common and affect approximately 10% to 80% of the general population. The condition typically presents with reflux-type symptoms and is diagnosed either with imaging or endoscopy. In this case, the hernia presented as G-induced abdominal pain. The patient was an F-18 pilot who experienced worsening epigastric abdominal pain proportionate to the amount of accelerative force experienced. The pain would occur at approximately 3 Gs and increase beyond that. The patient was asymptomatic at rest and denied any dysphagia or reflux symptoms. The only other symptom was the occurrence of a similar pain with diaphragmatic spasm, i.e., "hiccup." The patient underwent multiple imaging modalities and procedures and was eventually found to have a sliding hiatal hernia. He underwent a Nissen fundoplication to repair it. Approximately 3 months postoperatively, the patient was able to withstand significant acceleration without pain. He has no lasting sequelae from the hernia or surgery and continues to fly.
authors.affiliation: Naval Branch Health Clinic Fort Worth, 1711 Doolittle Avenue, Fort Worth, TX 76127.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Hughey
authors.affiliation: Naval Branch Health Clinic Fort Worth, 1711 Doolittle Avenue, Fort Worth, TX 76127.
authors.forename: Lauren H
authors.initials: LH
authors.lastname: Mattingly
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D006112:Gravitation; D006551:Hernia, Hiatal / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D000070356:Pilots