PDF(Pubmed)
Abstract：
Hiatal hernia is a frequent pathology in the population; however, the most frequent hiatal hernia is type I, which accounts for up to 95% incidence, types II, III, and IV being less frequent and representing between 5% and 15%, and even less common are giant hernias. The definition of the giant hernia is still not exact in the literature; some authors define giant or massive hiatal hernia as one in which the hernia occupies more than 30% of the stomach and/or passes from other abdominal structures to the thorax. We describe the case of a patient with gastrointestinal symptomology without response to a proton pump inhibitor, with base exacerbation that required imaging studies, showing a large hernia defect passing to the thorax from abdominal organs (stomach, spleen, mesenteric fat), as well as alteration of the gastric and spleen axis with ascent in pancreatic body and tail, which corresponds to a giant hiatal hernia. Said pathology is very infrequent, with recurrences and postoperative complications. Our patient recovered from the surgical procedure with therapeutic success.
摘要：
食管裂孔疝是人群中常见的病理；然而，最常见的食管裂孔疝是I型,发病率高达95%，II型,III,IV频率较低，占5%至15%，甚至更不常见的是巨大的疝气。文献中对巨大疝的定义仍然不准确；一些作者将巨大或巨大的食管裂孔疝定义为疝占据胃的30％以上和/或从其他腹部结构转移到胸部的疝。我们描述了对质子泵抑制剂无反应的胃肠道症状患者的情况，基础恶化需要影像学研究，显示从腹部器官（胃，脾,脾肠系膜脂肪)，以及随着胰体和胰尾的上升胃和脾轴的改变，相当于巨大的食管裂孔疝.所说的病理很少见，复发和术后并发症。我们的病人从外科手术中康复，治疗成功。
