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His general condition was notably affected, with antalgic posture, profuse sweating, tachycardia and tachypnea, BP was 100/60<span class="elsevierStyleHsp" style=""></span>mmHg. Abdominal examination revealed guarding. Lab work was normal. X-ray detected a large thoracic air-fluid level secondary to hiatal hernia associated with perforation of the hollow viscus and bilateral pneumoperitoneum. Urgent laparotomy was performed to reduce the hernial sac and resect it. A perforation was observed in the proximal third of the lesser curvature. We performed sutures, omentoplasty and closure of the crura of the diaphragm. The patient was discharged with no complications on the 7th day (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cerrato Delgado S, Peña Barturen C, Casado Maestre MD. Perforación gástrica en el seno de una hernia de hiato mixta. Cir Esp. 2021;99:381.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 651 "Ancho" => 1255 "Tamanyo" => 51858 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735077/0000009900000005/v1_202105210822/S2173507721001162/v1_202105210822/en/main.assets" "Apartado" => array:4 [ "identificador" => "15075" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Image of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735077/0000009900000005/v1_202105210822/S2173507721001162/v1_202105210822/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507721001162?idApp=UINPBA00004N" ]
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