A Pancreas Out of Place: Acute Interstitial Pancreatitis Caused by Pancreatic Herniation in a Type IV Paraesophageal Hernia
Division
Far West
Hospital
MountainView Hospital
Document Type
Case Report
Publication Date
8-13-2026
Keywords
acute pancreatitis, mechanical pancreatitis, pancreatic herniation, paraesophageal hernia, type IV hiatal hernia
Disciplines
Digestive System Diseases | Gastroenterology | Internal Medicine | Medicine and Health Sciences
Abstract
Pancreatic involvement in paraesophageal hernias is rare and can precipitate acute pancreatitis through mechanical compression or ischemia. We report an 82-year-old woman who presented with epigastric pain and an elevated lipase level. Imaging demonstrated a large type IV paraesophageal hernia containing the stomach, transverse colon, and pancreatic body and tail, with inflammatory changes localized to the pancreatic tail. Common causes of pancreatitis were excluded. The patient improved with conservative management and was referred for elective hernia repair after resolution of pancreatitis. This case highlights an uncommon mechanical cause of acute pancreatitis and the importance of anatomic evaluation in atypical presentations.
Publisher or Conference
ACG Case Reports Journal
Recommended Citation
Manjikian A, Diaz V, Hsu M, Stone C. A Pancreas Out of Place: Acute Interstitial Pancreatitis Caused by Pancreatic Herniation in a Type IV Paraesophageal Hernia. ACG Case Rep J. 2026;13(8):e02274. doi:10.14309/crj.0000000000002274