Grade IV Hiatal Hernia Resolved Laparoscopically with Diaphragmatic Hiatal Plasty and Fundoplication
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Abstract
Hiatal hernias are classified according to their anatomy into: Type I hiatal hernia, or sliding hiatal hernia, Type II (paraesophageal) hernia, Type III (mixed) and Type IV hiatal hernia is associated with a large defect in the phrenoesophageal membrane. Type IV hiatal hernia is a rare pathology with a low incidence in medical practice, but with great clinical relevance due to the risk of imminent morbidity; it is commonly repaired once identified due to concerns of acute gastric volvulus and strangulation of the stomach, although herniation and strangulation of some other intra-abdominal organ is not exempt. We present the clinical case of a patient with a grade IV hiatal hernia, incidental finding, relatively asymptomatic prior to clinical evaluation, repaired by laparoscopy; Performing reduction of the herniation of intra-abdominal organs, diaphragmatic plasty and fundoplication successfully, with a post-surgical evolution that was adequate.
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