# Unusual Presentation of Incarcerated True Parahiatal Hernia: Management of a Rare Clinical Entity

## TL;DR

This paper presents a rare case of a parahiatal hernia misdiagnosed as a heart condition, highlighting the importance of accurate diagnosis for proper treatment.

## Contribution

The paper adds to the limited literature by describing a rare clinical case of incarcerated parahiatal hernia with unusual presentation.

## Key findings

- Parahiatal hernia can present with symptoms resembling acute coronary syndrome.
- Accurate diagnosis is crucial as management differs from paraoesophageal hernia.
- Incarcerated parahiatal hernia is rare and often misdiagnosed.

## Abstract

True parahiatal hernia is a type of diaphragmatic hernia in which herniation occurs through a defect in the diaphragm, adjacent to the normal oesophageal hiatus. Its reported incidence is very rare, and it is commonly misdiagnosed as paraoesophageal hernia. Although the clinical distinction between paraoesophageal and parahiatal hernia is difficult, it is essential to recognise these two separate entities clinically as their management differs.

Clinical presentation of parahiatal hernia includes symptoms related to gastro-oesophageal reflux disease (GERD). Patients may also present emergently with symptoms of respiratory distress and chest symptoms. With that in mind, we describe a compelling case of a young lady who initially presented with symptoms suggestive of acute coronary syndrome. However, she was found to have an incarcerated parahiatal hernia.