An example of upper Gl bleeding in an incarcerated hiatal hernia is presented. The patient was sent, while bleeding, to Nuclear Medicine for a radioisotope bleeding scan that revealed a circular collection of radioactivity posterior to the myocardium. The impression concerning this accumulation was that it might be bleeding in a hiatal hernia, bleeding esophageal varices, or an aneurysm of the descending aorta. An esophagram and upper Gl series demonstrated a definite incarcerated hiatal hernia corresponding to the nuclear scintigraphic finding. In addition, upper endoscopy showed a large hiatal hernia containing several discrete erosions that were not bleeding actively.
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