Case Report

Esophageal Hiatal Hernia: A Possible Scintigraphic Feature


An 81-year-old woman with symptoms of upper Gastrointestinal (GI) obstruction but with no supporting evidence for obstruction in previous endoscopies was studied with a solid-liquid gastric emptying scintigraphic examination. There was evidence of accumulation of the tracer in a part of the stomach in the thorax before filling the stomach. The paraesophageal hiatal hernia was suspected. The diagnosis was not confirmed by other modalities and the patient passed away after upper GI bleeding a month later.

[1] Stylopoulos N, Gazelle GS, Rattner DW. Paraesophageal hernias: Operation or observation? Annals of Surgery. 2002; 236(4):492- 500. [DOI:10.1097/00000658-200210000-00012] [PMID] [PMCID]
[2] Cardile AP, Heppner DS. Gastric volvulus, Borchardt’s triad, and endoscopy: A rare twist. Hawaii Medical Journal. 2011; 70(4):80-2. [PMID] [PMCID]
[3] Shih WJ, Milan PP. Gastric-emptying scintigraphy of type III hiatal hernia: A case report. Journal of Nuclear Medicine Technology. 2005; 33(2):83-5. [PMID]
[4] Tulchinsky M, Eggli DF. Transmission image aids in diagnosis of hiatus hernia during gastric emptying study. Clinical Nuclear Medicine. 1996; 21(12):999-1000. [DOI:10.1097/00003072-199612000- 00028] [PMID]
[5] Kohn GP, Price RR, DeMeester SR, Zehetner J, Muensterer OJ, Awad Z, et al. Guidelines for the management of hiatal hernia. Surgical Endoscopy. 2013; 27(12):4409-28. [DOI:10.1007/s00464-013-3173- 3] [PMID]
[6] Andujar JJ, Papasavas PK, Birdas T, Robke J, Raftopoulos Y, Gagne DJ, et al. Laparoscopic repair of large paraesophageal hernia is associated with a low incidence of recurrence and reoperation. Surgical Endoscopy. 2004; 18(3):444-7. [DOI:10.1007/s00464-003-8823-4] [PMID]
[7] Barrett NR. Hiatus hernia: A review of some controversial points. The British Journal of Surgery. 1954; 42(173):231-44. [DOI:10.1002/ bjs.18004217303] [PMID]
[8] Kavic SM, Segan RD, George IM, Turner PL, Roth JS, Park A. Classification of hiatal hernias using dynamic three dimensional reconstruction. Surgical Innovation. 2006; 13(1):49-52. [DOI:10.1177/15 5335060601300108] [PMID]
[9] Landreneau RJ, Del Pino M, Santos R. Management of paraesophageal hernias. The Surgical Clinics of North America. 2005; 85(3):411-32. [DOI:10.1016/j.suc.2005.01.006] [PMID]
[10] Eren S, Gümüş H, Okur A. A rare cause of intestinal obstruction in the adult: Morgagni’s hernia. Hernia: The Journal of Hernias and Abdominal Wall Surgery. 2003; 7(2):97-9. [DOI:10.1007/s10029- 002-0099-4] [PMID]
[11] Cohen R, Loarte P, Navarro V, Mirrer B. Echocardiographic findings in pulmonary embolism: An important guide for the management of the patient. World Journal of Cardiovascular Diseases. 2012; 2(3):161-4. [DOI:10.4236/wjcd.2012.23027]
[12] Eren S, Ciriş F. Diaphragmatic hernia: Diagnostic approaches with review of the literature. European Journal of Radiology. 2005; 54(3):448-59. [DOI:10.1016/j.ejrad.2004.09.008] [PMID]
[13] Boushey RP, Moloo H, Burpee S, Schlachta CM, Poulin EC, Haggar F, et al. Laparoscopic repair of paraesophageal hernias: A Canadian experience. Canadian Journal of Surgery. 2008; 51(5):355-60. [PMID] [PMCID]
[14] Ott DJ, Gelfand DW, Chen YM, Wu WC, Munitz HA. Predictive relationship of hiatal hernia to reflux esophagitis. Gastrointestinal Radiology. 1985; 10(4):317-20. [DOI:10.1007/BF01893120] [PMID]
[15] Witkosky ME, Waxman AD. Discordant emptying from hiatal hernia and stomach with severe esophageal reflux demonstrated by gastric scintigraphy. Clinical Nuclear Medicine. 2010; 35(3):187-8. [DOI:10.1097/RLU.0b013e3181cc6455] [PMID]
IssueVol 6 No 2 (2021): Mar/Apr QRcode
SectionCase Report(s)
Gastric emptying Hiatal hernia Scintigraphy

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How to Cite
Farzanefar S, Zarei M, Mirzabeigi A, Abbasi M. Esophageal Hiatal Hernia: A Possible Scintigraphic Feature. CRCP. 2021;6(2):47-50.