Case 27-1971

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Abstract
Presentation of Case First admission. A 73-year-old man was admitted to the hospital because of melena.For many years he had experienced nocturnal episodes of postprandial epigastric "pressure" and bloating, occurring only in recumbency and not relieved by the ingestion of milk or alkali. Twelve years before admission melena occurred. An upper gastrointestinal series disclosed a sliding hiatus hernia, 8 by 5 cm. After transthoracic repair of the hiatus hernia the gastrointestinal symptoms disappeared. Eleven years before entry he began to have substernal "pressure" on exertion, with radiation to the left arm and the jaw; relief was obtained by . . .
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