PDF(Pubmed)
Abstract：
Hiatal hernias occur when intra-abdominal contents protrude into the diaphragmatic opening. Of the four classifications, Type 4 hiatal hernias are the most rare and severe. They develop from herniation of the gastroesophageal junction and abdominal viscera other than the stomach into the thoracic cavity. The resulting increase in intrathoracic pressure can cause a wide variety of symptoms on presentation and potentially lead to misdiagnosis. We present a rare case in which a 78-year-old woman presented with nonspecific symptoms and was diagnosed with incarcerated Type 4 hiatal hernia with sigmoid volvulus. We also report a literature review from 2015 to emphasize the importance of recognizing diverse symptomatic presentations in complex Type 4 hiatal hernias and the need for a comprehensive evaluation, as early detection and prompt intervention are essential in preventing life-threatening complications.
摘要：
当腹腔内容物突出到膈开口处时，就会发生食管裂孔疝。在四种分类中，4型食管裂孔疝是最罕见和最严重的。它们是从胃食管交界处和除胃以外的腹部内脏突出到胸腔中发展而来的。由此引起的胸内压的升高可在出现时引起各种各样的症状并可能导致误诊。我们介绍了一例罕见的病例，其中一名78岁的妇女表现出非特异性症状，并被诊断出患有乙状结肠扭转的4型食管裂孔疝。我们还报告了2015年的文献综述，强调在复杂的4型食管裂孔疝中认识到不同症状表现的重要性，以及需要进行全面评估。早期发现和及时干预对于预防危及生命的并发症至关重要。
