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Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum. There are a few published cases of small bowel herniation into the thoracic cavity in the literature. Our patient represents a rare case of an individual diagnosed with type IV PEH with herniation of jejunum with perforated diverticula. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 38-year-old man presented with acute abdomen and peritonitis after accidently sustaining kick to the abdomen while playing soccer and results of his Computed tomography scan of the abdomen showed a large soft tissue mass with complex density Hounsfield units. It mentions GI stromal tumors (GISTs) consider as a rare malignant tumors originating from the intestinal cells of Cajal.