Small bowel obstruction caused by hiatal hernia

Background: A hiatal hernia is caused by herniation of a portion of the stomach or other abdominal viscera into the thorax through the esophageal hiatus of the diaphragm. It is a common condition and asymptomatic in most cases. Case report: We present the case of a 52-year-old male with a past medic...

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Main Authors: Jacob Cabrejas, Kara Zweerink, Wesley Eilbert
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:JEM Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773232025000446
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author Jacob Cabrejas
Kara Zweerink
Wesley Eilbert
author_facet Jacob Cabrejas
Kara Zweerink
Wesley Eilbert
author_sort Jacob Cabrejas
collection DOAJ
description Background: A hiatal hernia is caused by herniation of a portion of the stomach or other abdominal viscera into the thorax through the esophageal hiatus of the diaphragm. It is a common condition and asymptomatic in most cases. Case report: We present the case of a 52-year-old male with a past medical history of previous hiatal hernia repair who presented to the emergency department with one day of diffuse abdominal pain and multiple episodes of emesis. Bowel sounds were heard on auscultation of his left chest. Computed tomography of the abdomen and pelvis demonstrated multiple abdominal contents herniating through the esophageal hiatus. Multiple dilated loops of small bowel were seen in the left hemithorax with decompressed small bowel seen more distally, indicating a small bowel obstruction with a transition point in the thoracic cavity.Why should an emergency physician be aware of this? Hiatal hernia is a common condition. While rare, large hiatal hernias may result in herniation of small bowel with the potential complication of bowel obstruction.
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spelling doaj-art-e76519a6b72e443ab5ffbf16582f465e2025-08-20T03:24:22ZengElsevierJEM Reports2773-23202025-09-014310018010.1016/j.jemrpt.2025.100180Small bowel obstruction caused by hiatal herniaJacob Cabrejas0Kara Zweerink1Wesley Eilbert2Department of Emergency Medicine, University of Illinois College of Medicine, Room 469 COME, 1819 W Polk St, Chicago, IL, 60612, USADepartment of Emergency Medicine, University of Illinois College of Medicine, Room 469 COME, 1819 W Polk St, Chicago, IL, 60612, USACorresponding author.Department of Emergency Medicine, University of Illinois College of Medicine, Room 469 COME 1819 W Polk St. Chicago, IL. 60612, USA.; Department of Emergency Medicine, University of Illinois College of Medicine, Room 469 COME, 1819 W Polk St, Chicago, IL, 60612, USABackground: A hiatal hernia is caused by herniation of a portion of the stomach or other abdominal viscera into the thorax through the esophageal hiatus of the diaphragm. It is a common condition and asymptomatic in most cases. Case report: We present the case of a 52-year-old male with a past medical history of previous hiatal hernia repair who presented to the emergency department with one day of diffuse abdominal pain and multiple episodes of emesis. Bowel sounds were heard on auscultation of his left chest. Computed tomography of the abdomen and pelvis demonstrated multiple abdominal contents herniating through the esophageal hiatus. Multiple dilated loops of small bowel were seen in the left hemithorax with decompressed small bowel seen more distally, indicating a small bowel obstruction with a transition point in the thoracic cavity.Why should an emergency physician be aware of this? Hiatal hernia is a common condition. While rare, large hiatal hernias may result in herniation of small bowel with the potential complication of bowel obstruction.http://www.sciencedirect.com/science/article/pii/S2773232025000446Hiatal herniaGiant hiatal herniaType IV hiatal herniaMassive hiatal herniaLarge hiatal herniaSmall bowel obstruction
spellingShingle Jacob Cabrejas
Kara Zweerink
Wesley Eilbert
Small bowel obstruction caused by hiatal hernia
JEM Reports
Hiatal hernia
Giant hiatal hernia
Type IV hiatal hernia
Massive hiatal hernia
Large hiatal hernia
Small bowel obstruction
title Small bowel obstruction caused by hiatal hernia
title_full Small bowel obstruction caused by hiatal hernia
title_fullStr Small bowel obstruction caused by hiatal hernia
title_full_unstemmed Small bowel obstruction caused by hiatal hernia
title_short Small bowel obstruction caused by hiatal hernia
title_sort small bowel obstruction caused by hiatal hernia
topic Hiatal hernia
Giant hiatal hernia
Type IV hiatal hernia
Massive hiatal hernia
Large hiatal hernia
Small bowel obstruction
url http://www.sciencedirect.com/science/article/pii/S2773232025000446
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