Medics failed to spot man's hernia, says coroner

A coroner has warned about a "lack of understanding" among medics of strangulated hiatus hernia after the condition went undiagnosed in a man who later died.

Tom Glover, who was in his early 70s, was assessed and discharged from Ipswich Hospital in April 2024, after presenting with symptoms of gastroenteritis.

The next day, he was readmitted, suffered a cardiac arrest, and transferred to Broomfield Hospital in Essex, where he died on 22 May.

In a prevention of future deaths report, senior coroner Nigel Parsley said: "Many non-gastro specialist medical clinicians within the NHS are unaware of the difference in the two types of hiatus hernia and are therefore unaware of the additional risks."

In the report, Mr Parsley said that if an earlier diagnose of Mr Glover's strangulated hiatus hernia was made it could not be established whether it would have prevented the outcome.

At the inquest into the death of Mr Glover, it was heard that he attended Ipswich Hospital on 13 April 2024, where he was admitted onto an assessment unit for observations overnight and the following evening "was deemed to be clinically well enough for discharge".

On the 15 April, he became acutely unwell and returned to Ipswich Hospital where he suffered a cardiac arrest.

Mr Glover was resuscitated and diagnosed with a strangulated hiatus hernia, and transferred to Broomfield Hospital.

In the report, Mr Parsley stated: "It was heard in evidence that in England many non-gastro specialist medical clinicians within the NHS are unaware of the difference in the two types of hiatus hernia and therefore unaware of the additional risk posed to the 5-15% of patients with a para-oesophageal hiatus hernia."

He added that as a result, "the lack of understanding of the difference between the two types" of hernia means that "there is no increased vigilance" when individuals present symptoms.

A sliding hiatus hernia moves up and down through the naturally occurring hole in the diaphragm, while a para-oesophageal hiatus hernia – also called a rolling hernia – sees part of the stomach push up through the hole in the diaphragm.

Despite intensive care unit support and emergency surgeries, the coroner said he had suffered irreversible damage to his gastrointestinal system, that he could not survive.

The inquest concluded on 10 March that Mr Glover had died from naturally occurring strangulation of a hiatus hernia with delayed surgical intervention resulting from an earlier missed opportunity for earlier diagnosis.

Mr Parsley sent a prevention of future deaths report to the Department of Health and Social Care and the British Society of Gastroenterology.

The BBC have approached both organisations for comment.

Ipswich Hospital declined to comment.

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