Unusual Presentation of Incarcerated True Parahiatal Hernia: Management of a Rare Clinical Entity

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 3; p. e57152
• Main Authors: Loo, Guo Hou, Muthkumaran, Guhan, Ritza Kosai, Nik
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 28-03-2024; Cureus
• Subjects: Abdomen; Diaphragm (Anatomy); Gastroenterology; Gastroesophageal reflux; General Surgery; Hiatal hernias; Laparoscopy; Pain; Polyesters; Stomach; Surgery; Sutures; Thorax; gerd; tension free mesh repair; upper gi; paraoesophageal hernia; incarcerated hernia; fundoplication; parahiatal hernia
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.57152

True parahiatal hernia is a type of diaphragmatic hernia in which herniation occurs through a defect in the diaphragm, adjacent to the normal oesophageal hiatus. Its reported incidence is very rare, and it is commonly misdiagnosed as paraoesophageal hernia. Although the clinical distinction between paraoesophageal and parahiatal hernia is difficult, it is essential to recognise these two separate entities clinically as their management differs. Clinical presentation of parahiatal hernia includes symptoms related to gastro-oesophageal reflux disease (GERD). Patients may also present emergently with symptoms of respiratory distress and chest symptoms. With that in mind, we describe a compelling case of a young lady who initially presented with symptoms suggestive of acute coronary syndrome. However, she was found to have an incarcerated parahiatal hernia.