<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1025-0255</journal-id>
<journal-title><![CDATA[Revista Archivo Médico de Camagüey]]></journal-title>
<abbrev-journal-title><![CDATA[AMC]]></abbrev-journal-title>
<issn>1025-0255</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Camagüey]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1025-02552020000100013</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hernia hiatal tipo IV: presentación de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Hiatal hernia type IV: case presentation]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira-Recio]]></surname>
<given-names><![CDATA[Héctor Ignacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guevara-Almeida]]></surname>
<given-names><![CDATA[Yordany]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerra-Menéndez]]></surname>
<given-names><![CDATA[José Ramón]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerra-González]]></surname>
<given-names><![CDATA[Alfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Camagüey Hospital Universitario Manuel Ascunce Domenech Servicio de Imagenología]]></institution>
<addr-line><![CDATA[Camagüey ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2020</year>
</pub-date>
<volume>24</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1025-02552020000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1025-02552020000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1025-02552020000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento: la hernia hiatal es la anormalidad más frecuente del tracto digestivo superior, se clasifica en cuatro tipos, estas hernias pueden ser por deslizamiento y paraesofágicas, estas últimas de presentación mucho menos frecuente en la práctica clínica como es el caso que se presentó tipo IV; la mayoría son asintomáticas son descubiertas incidentalmente en radiografías de tórax o en tomografía computarizada multicorte y cuando son sintomáticas muchas veces están asociadas a complicación.  Objetivo:  presentar un paciente con hernia hiatal tipo IV diagnosticada por tomografía computarizada multicorte.  Presentación del caso:  paciente masculino, de 58 años de edad, con antecedentes de hipertensión arterial, que refiere presentar una hernia diafragmática diagnosticada hace 15 años, que presenta dolor abdominal a tipo cólico de moderada intensidad acompañado de distensión abdominal eructos, vómitos y disnea. Al examen físico, abdomen globuloso que sigue los movimientos respiratorios, doloroso a la palpación superficial y profunda. En el tórax se auscultan ruidos hidroaéreos en el lado derecho. La tomografía computarizada multicorte demuestra la herniación de estómago, colon transverso y epiplón en hemitórax derecho a través del hiato esofágico.  Conclusiones:  las hernias hiatales son las anomalías más frecuentes del tracto digestivo superior pero las gigantes tipo IV con herniación de otras estructuras abdominales, como colon, omento, intestino delgado, hígado y páncreas son una forma infrecuente de presentación de las mismas. La tomografía computarizada multicorte y el estudio baritado de esófago-estómago-duodeno, resultan fundamentales para el diagnóstico y caracterización de estas lesiones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background:  the hiatal hernia is the most frequent abnormality of the upper digestive tract, which are classified into four types, these hernias can be by sliding and paraesophageal, the latter being much less frequent presentation in clinical practice as is the case presented type IV; most of them are asymptomatic and are discovered incidentally on chest x-rays or multi-slice CT and when they are symptomatic they are often associated with complications.  Objective:  to describe a patient with hiatal hernia type IV diagnosed by multi-slice CT.  Case report:  a 58-year-old male patient with a history of arterial hypertension, who reported having a diaphragmatic hernia diagnosed 15 years ago, who presents with abdominal pain with a moderate intensity of colic accompanied by abdominal distension, belching, vomiting, and dyspnea. At physical examination, globular abdomen that follows the respiratory movements, painful to superficial and deep palpation. Hydro-aerial noises are heard in the right side of the thorax. Multi-slice CT shows herniation of the stomach, transverse colon and omentum in the right chest cavity through the esophageal hiatus.  Conclusions:  hiatal hernias are the most frequent anomalies of the upper digestive tract but type IV giants with herniation of other abdominal structures, such as colon, omentum, small intestine, liver and pancreas are an infrequent form of presentation of them. Multi-slice CT and barium study of the esophagus, stomach and duodenum are fundamental for the diagnosis and characterization of these lesions.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[HERNIA HIATAL/clasificación]]></kwd>
<kwd lng="es"><![CDATA[HERNIA HIATAL/diagnóstico por imagen]]></kwd>
<kwd lng="es"><![CDATA[ENEMA OPACO/métodos]]></kwd>
<kwd lng="es"><![CDATA[TOMOGRAFÍA COMPUTARIZADA MULTIDETECTOR]]></kwd>
<kwd lng="es"><![CDATA[INFORMES DE CASOS]]></kwd>
<kwd lng="en"><![CDATA[HERNIA, HIATAL/classification]]></kwd>
<kwd lng="en"><![CDATA[HERNIA, HIATAL/diagnostic imaging]]></kwd>
<kwd lng="en"><![CDATA[BARIUM ENEMA/methods]]></kwd>
<kwd lng="en"><![CDATA[MULTIDETECTOR COMPUTED TOMOGRAPHY]]></kwd>
<kwd lng="en"><![CDATA[CASE REPORTS]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Villarreal]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Bernal]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Cabrera]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez Ussa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pedraza]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hernia hiatal mixta con vólvulo gástrico intratorácico reporte de caso y revisión de la literatura]]></article-title>
<source><![CDATA[Rev Hispanoam Hernia]]></source>
<year>2018</year>
<volume>6</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>186-90</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marinos]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Moris]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Yettimis]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Varsamidakis]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Type IV paraesophageal hernia as a cause of ileus Report of a case]]></article-title>
<source><![CDATA[Int J Surg Case Rep]]></source>
<year>2015</year>
<volume>6</volume>
<page-range>43-5</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Madriz]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Víctor Alvarado]]></surname>
<given-names><![CDATA[VH]]></given-names>
</name>
<name>
<surname><![CDATA[Jaén]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnóstico radiológico de hernia hiatal (Revisión bibliográfica y presentación de casos)]]></article-title>
<source><![CDATA[Rev Med Cos Cen]]></source>
<year>2008</year>
<volume>65</volume>
<numero>583</numero>
<issue>583</issue>
<page-range>103-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[HX]]></given-names>
</name>
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Xue]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[ZF]]></given-names>
</name>
<name>
<surname><![CDATA[Xin]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Esophagealhiatal hernia risk, diagnosis and management]]></article-title>
<source><![CDATA[Expert Rev Gastroenterol Hepatol]]></source>
<year>2018</year>
<volume>12</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>319-29</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Viscarra]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Ríos]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hernia hiatal un desafío diagnóstico y terapéutico. A propósito de un caso]]></article-title>
<source><![CDATA[MÉD UIS]]></source>
<year>2017</year>
<volume>30</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>83-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bermúdez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gran hernia paraesofágica con estómago intratorácico total Informe de un caso y revisión de la literatura]]></article-title>
<source><![CDATA[Rev Col Gastroenterol]]></source>
<year>2006</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>64-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mora-Guzmán]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[del-Pozo-Jiménez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Martín-Pérez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A giant hiatal hernia and intrathoracic pancreas]]></article-title>
<source><![CDATA[Rev Esp Enferm Dig]]></source>
<year>2017</year>
<volume>109</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>458-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Banimostafavi]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Tayebi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Large hiatal hernia with pancreatic body herniation Case-report]]></article-title>
<source><![CDATA[Ann Med Surg]]></source>
<year>2018</year>
<volume>28</volume>
<page-range>20-2</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Farhat]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Towle]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidental Hiatal Hernia on Chest X-ray]]></article-title>
<source><![CDATA[JETem]]></source>
<year>2018</year>
<volume>3</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>29-30</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weitzendorfer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Köhler]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Antoniou]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Pallwein Prettner]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Manzenreiter]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Schredl]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Preoperative diagnosis of hiatal hernia: barium swallow X ray, high-resolution manometry, or endoscopy?]]></article-title>
<source><![CDATA[Eur Surg]]></source>
<year>2017</year>
<volume>49</volume>
<page-range>210-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
