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This case report is about a 43 year old man, who presented with a large paraesophageal hiatal hernia. Hiatal hernias are common and often asymptomatic. However, this patient’s hernia was caused by a large defect in his diaphragm, into which his stomach, multiple loops of small bowel and even part of his colon had herniated, causing recurrent gastric obstruction. While this is a condition that develops slowly, over time in most patients, this case of hiatal hernia likely results from a congenital defect, given his relatively young age, the size of the defect and his associated anatomical abnormalities. This report details his presentation and surgical repair, complemented with corresponding images.
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