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Risk of volvulus
There is an element of volvulus in the hernia always. In symptomatic patients risk is high. In the asymptomatic it is around 1% / year
Diagnosis and Rx
CXR( gastric bubble behind the cardiac shadow). Barium swallow. OGD not reliable. Rx NGT
Surgery
Reduce the hernia, resection of sac, approximate the crus and some kind of gastric fixation.
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