Incarceration with or without strangulation of a hiatus hernia is a serious complication occuring more frequently in the paraesophageal type than in the sliding variety. Most case reports of strangulation1-5 have been in patients with post-traumatic diaphragmatic hernias or pleuroperitoneal hernias rather than in those with hiatal hernias. It is not uncommon to find in a large paraesophageal hiatus hernia that there is a portion of the colon, as well as stomach, in the hernial sac. It is, however, distinctly unusual to find a hiatus hernia in which stomach has been replaced by a portion of the proximal transverse colon with the occurrence of incarceration and, in addition, obstruction of the duodenum as the result of external pressure by the colon. The following case demonstrates this sequence of events and appears to be unique in the literature.
Report of a Case
The present admission was the