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Medical and Surgical Aspects of Hiatus Hernia

Burton Shatz, MD; Arthur E. Baue, MD; Stanford Wessler, MD; Louis V. Avioli, MD
JAMA. 1970;214(1):125-129. doi:10.1001/jama.1970.03180010067016.
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Dr. Bernard Sunshine, First-Year Resident in Surgery, the Jewish Hospital of St. Louis, and Assistant in Surgery, Washington University School of Medicine: A 38-year-old white businessman was admitted to Jewish Hospital on Dec 10, 1968, with a chief complaint of indigestion beginning when he was a teenager. At that time, he began to notice pain following the ingestion of spicy foods or large meals. The pain was characterized as mild, nonradiating, and epigastric in location. It was associated with eructation and flatulence lasting 15 to 30 minutes and subsiding spontaneously. Antacids brought significant relief.

During the five years prior to admission, the symptoms increased in intensity and frequency. They were exacerbated by lying supine and were only mildly relieved by standing or lying with the head of the bed elevated. For two years prior to admission, the patient complained of difficulty with swallowing, stating that the food would "get stuck"


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