Traumatic right paraesophageal hernia after Belsey Mark IV fundoplication

We report the case of a 70-year-old woman with a long history of achalasia and gastroesophageal reflux disease who presented with an acute right-sided paraesophageal hernia after a motor vehicle accident. Six months before the accident, she underwent an elective Belsey Mark IV fundoplication to reduce a hiatal hernia. The traumatic paraesophageal hernia traversed the diaphragm at a weakness opposite the fundoplication. The clinical presentation, surgical management, and previous literature are discussed.