An 87-year-old woman presented with complaints of severe intermittent chest pain. Upper GI series and endoscopy showed a large paraesophageal hernia with intermittent volvulus.
CT scan shows a large portion of the stomach above the diaphragm. The spleen was not herniated into the chest. Because of the risk of strangulation with a symptomatic hernia of this size, the patient elected to have surgery.
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