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dc.contributor.authorMukundu Nagesh, Navin
dc.contributor.authorOsilli, Dixon
dc.contributor.authorKhoo, David
dc.identifier.citationMukundu Nagesh, N., Osilli, D. and Khoo, D. (2020) 'Giant hiatus hernia presenting as a chronic cough masking a sinister diagnosis.', BMJ case reports, 13(12). doi: 10.1136/bcr-2020-235802.
dc.description.abstractWe present a case of an 82-year-old gentleman with an 18-month history of productive cough. Urgent CT scan of the thorax revealed type 1 hiatus hernia (HH). The patient was managed conservatively with lifestyle modifications to help his reflux symptomology. The patient subsequently presented with acute shortness of breath and vomiting. Repeat CT scan reported a giant incarcerated HH (15?cm). Endoscopy revealed an incidental finding of a 3?cm polypoid lesion in the oesophagus at the level of the carina and histology of biopsies reported an invasive adenocarcinoma. During admission, the patient unfortunately had a hospital acquired infection and cardiac complications which prevented surgical intervention. Patients with suspected HH should be investigated thoroughly with imaging studies including chest X-ray, CT or MRI alongside oesophageal manometry and gastroscopy. Endoscopic evaluation is particularly important as these patients are at higher risk of Barrett's oesophagus and invasive malignancy.
dc.rights© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.
dc.subjectAged, 80 and over
dc.subjectTomography, X-Ray Computed
dc.subjectcancer intervention
dc.subjectEsophageal Neoplasms/*diagnosis/pathology
dc.subjectGastroesophageal Reflux/etiology
dc.subjectgastrointestinal surgery
dc.subjectgeneral surgery
dc.subjectHernia, Hiatal/complications/*diagnostic imaging
dc.subjectRadiography, Thoracic
dc.titleGiant hiatus hernia presenting as a chronic cough masking a sinister diagnosis.
dc.typeJournal Article
dc.identifier.journalBMJ case reports
dc.description.noteRD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.
dc.description.admin-notePublished version, accepted version (12 month embargo), submitted version

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