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According to Health Central a strangulated hiatal hernia requires immediate medical attention. If the herniated part of the stomach becomes strangulated you'll experience severe chest pain, difficulty swallowing and bloating. The part of your stomach not recieving blood because it's become herniated can develop lesions (wounds) and you can become anemic from the blood loss. E-medicine call a strangulated hiatial hernia a true emergency.    The surgery can done using a small incision and guiding a laparoscope or tiny video camera that minimizes recovery time.   http://www.hmc.psu.edu/healthinfo/h/hiatalhernia.htm   http://www.emedicinehealth.com/hiatal_hernia/page3_em.htm   http://www.healthcentral.com/chronic-pain/guide-154415-75.htm   Good luck!