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Updated: Mar 4, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Acute gastric outlet obstruction secondary to exclusive paraoesophageal small bowel herniation: a case report
Jean-Charles de Schoutheete1, Alex M Reece-Smith1, Saj A Wajed1
1a Department of Upper Gastro-Intestinal Surgery , Royal Devon and Exeter Hospital , Exeter , UK.
Introduction:
Herniation of abdominal viscera into the thorax may occur as a consequence of abnormal defects in the diaphragm. In adults, the most common condition relates to herniations through a weakened crural orifice via which the oesophagus normally traverses. These hiatus hernias are classified as types I-IV depending on the extent of visceral involvement.
Case Report:
We present here a case of type IV hiatus hernia with massive mediastinal herniation of the small bowel, yet remarkable in that the stomach itself remained completely intra-abdominal. Gastric outlet obstruction occurred as a consequence of extrinsic proximal small bowel compression.
Discussion:
To our knowledge this is the first reported case of paraoesophageal hernia exclusively involving small bowel, without involving any part of the stomach, and yet causing gastric outlet obstruction.
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