An 8-month-old infant with recurrent chest infections is found to have herniation of the gastric fundus alongside a normally positioned gastroesophageal junction through the esophageal hiatus. Which complication makes surgical repair mandatory even when the child is asymptomatic?

• A Gastric volvulus with strangulation ✓
• B Barrett's oesophagus
• C Iron deficiency anemia
• D Peptic stricture of the esophagus

Explanation

This describes a paraesophageal (rolling) hiatus hernia, where the fundus herniates beside a normally placed gastroesophageal junction. Because the herniated stomach can rotate and undergo organoaxial volvulus with strangulation and gangrene, elective repair is advised even in asymptomatic patients. Reflux complications such as Barrett's oesophagus and peptic stricture are characteristic of sliding hernias, in which the gastroesophageal junction itself migrates above the diaphragm.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.