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Related Concept Videos

Gross Anatomy of the Stomach01:16

Gross Anatomy of the Stomach

The human stomach is a vital part of the digestive system, performing multiple functions. It is located within the peritoneum, a serous membrane that lines the abdominal cavity. The stomach plays a central role in processing food substances and interacts with other digestive organs through coordinated digestive processes. The stomach has a characteristic J-shape and is divided into four main regions. The cardia is the first section where the esophagus connects to the stomach and is the entry...
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A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
Stomach Histology01:26

Stomach Histology

The stomach comprises several layers that work together to facilitate digestion and protect the organ. The outermost layer is called the serosa, which provides support and protection to the stomach. The muscularis externa layer is responsible for the mechanical breakdown of food by contracting and moving the stomach. The submucosa layer, located beneath the muscularis externa, contains connective tissue, blood vessels, nerves, and glands that secrete mucus and other substances essential for...
Gallbladder01:17

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Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
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Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation
05:50

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Published on: September 22, 2023

The hole in the stomach.

Hans Bödeker1, Steffen Leinung, Henning Wittenburg

  • 1Department of Internal Medicine II, University of Leipzig, 04103 Leipzig, Germany.

Diagnostic and Therapeutic Endoscopy
|May 22, 2008
PubMed
Summary

A diaphragmatic hernia caused severe upper abdominal pain and chest discomfort in a 57-year-old woman. Surgical repair of the diaphragmatic defect and resection of necrotic gastric tissue led to a full recovery.

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Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Surgery

Background:

  • Diaphragmatic hernias, particularly those involving the gastric fundus, can present with non-specific upper abdominal and chest symptoms.
  • Prompt diagnosis and intervention are crucial for managing incarcerated hernias to prevent complications like gastric necrosis.

Observation:

  • A 57-year-old female presented with acute upper abdominal pain and left-sided chest discomfort.
  • Initial investigations ruled out cardiac and pulmonary etiologies, prompting upper gastrointestinal endoscopy.
  • Endoscopic examination revealed a significant herniation of the gastric fundus through a diaphragmatic defect.

Findings:

  • Fluoroscopy confirmed a diaphragmatic hernia with gastric fundus incarceration.
  • Laparotomy identified a 3 cm diaphragmatic orifice.
  • Partial gastric fundus necrosis was observed due to incarceration.

Implications:

  • Surgical correction of diaphragmatic hernias, including widening the orifice and resecting compromised tissue, is effective.
  • Early diagnosis and surgical management of gastric fundus herniation can lead to complete patient recovery.
  • This case highlights the importance of considering diaphragmatic hernias in the differential diagnosis of unexplained upper abdominal and chest pain.