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AMA Arch Surg. 1952;65(5):665-672. doi:10.1001/archsurg.1952.01260020657003.
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AN ESOPHAGEAL hiatus hernia is frequently asymptomatic or unsuspected until it is discovered accidentally when roentgenograms of the gastrointestinal tract are made because of other pathology.1 Not uncommonly, however, such hernias do produce symptoms. It is important to note that these symptoms, although mild and intermittent, form a definite symptom complex if truly caused by hiatus hernia. This symptom complex consists of substernal or epigastric pain, acid eructations, and, most characteristically, aggravation of the pain precipitated by maneuvers which increase intra-abdominal pressure.2

Because of the fact that many esophageal hiatus hernias are asymptomatic and many of those that are symptomatic are only mildly so, there has been a controversy as to what should be done about them. Errors in diagnosis are frequent, and the significance of hiatus hernia is often overlooked. Frequently the dilemma is solved (?) by the physician by prescribing medical treatment consisting of a bland


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