Mechanism of Obstruction in Para-Esophageal Diaphragmatic Hernias

Obstruction in cases of para-esophageal hernia was encountered in 4 patients, 2 women, aged 70 and 77 and two men, aged 54 and 61. Observation revealed the mechanism involved. In every case the cardiac portion of the stomach had redescended into its original intra-abdominal location while the fundic portion had remained in the hernial sac. When the cardiac portion was replaced in the hernial sac, the obstruction was relieved. When the stomach was contained entirely within the sac of the para-esophageal hernia, there was no obstruction.