True parahiatal hernia: a case of laparoscopic management for a rare type of diaphragmatic hernia

Abstract

Parahiatal hernias are the rare variant of a diaphragmatic hernias. They are characterized by the formation of the neck of the hernia sac laterally to the diaphragm crura (usually the left), which distinguishes them from hiatal hernias. Hernia usually affects the fundus and body of the stomach, the esophagogastric junction remains below the level of the diaphragm, and clinical manifestations are associated with episodes of strangulation or axial volvulus. The article describes a case of parahiatal hernia complicated by chronic gastric volvulus with subsequent development of acute axial volvulus, which required urgent laparoscopic management.