Intrathoracic Stomach: When does it Obstruct?

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Abstract
Large esophageal and paraesophageal gastric herniations may occasionally produce gastric obstruction and strangulation. Seven cases of gastric intrathoracic herniation of varying degree, including 2 with obstruction, are presented. The cases with obstruction are discussed in relation to existing theories of the mechanism of obstruction: tightness of the hernial ring; acute volvulus of the herniated stomach; and subdiaphragmatic redescent of the fundus with fundic distension and crowding of the hernial orifice. The last mechanism is the most common, but a combination of mechanisms produces the obstruction in some cases.

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