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Journal articles on the topic 'Hiatal hernia'
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Puttaraju, Shashidhara, and Sanhitha Purushotham. "Study on incidence of hiatus hernia in patients undergoing upper gastrointestinal endoscopy for upper gastrointestinal symptoms in a secondary care hospital." International Surgery Journal 8, no. 3 (February 25, 2021): 935. http://dx.doi.org/10.18203/2349-2902.isj20210930.
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Background: Hiatus hernia refers to condition in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum.Hiatal hernia is a frequent finding during upper gastrointestinal endoscopy. Type I hiatal hernia is the sliding hiatal hernia, which accounts for more than 95% of all hiatal hernias with the remaining 5% being paraesophageal hiatal hernias taken together. Surgical therapy is recommended for patients with severe and refractory GERD symptoms such as poor compliance to long-term medical therapy and young patients wishing to avoid lifetime medical treatment. The objective of this study was to identify the associated symptoms and to determine diagnostic accuracy of endoscopic evaluation in patients with hiatus hernia.Methods: Current retrospective study comprised of 250 patients who presented with complaints of upper gastrointestinal symptoms and underwent upper gastrointestinal endoscopy in JSS hospital, Chamarajnagar during the period of October 2018 to May 2020.Results: Out of 250 patients, 162 males (64.8%) and 88 females (35.2%) were part of the study, who presented with upper GI symptoms, 12 (4.8%) patients were diagnosed with hiatus hernia. Out of these 12 cases, 9 patients (75%) were found to be having sliding type of hiatus hernia and 3 patients (25%) having rolling type.Conclusions: Early diagnosis and timely management or surgical intervention reduces morbidity associated with hiatus hernia and acid reflux. Hence, all patients presenting with persistent upper gastrointestinal symptoms should undergo upper GI endoscopy managed accordingly.
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Tatum, James M., Kamran Samakar, Michael E. Bowdish, Wendy J. Mack, Nikolai Bildzukewicz, and John C. Lipham. "Videoesophagography versus Endoscopy for Prediction of Intraoperative Hiatal Hernia Size." American Surgeon 84, no. 3 (March 2018): 387–91. http://dx.doi.org/10.1177/000313481808400322.
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Magnetic sphincter augmentation is a novel surgical procedure for gastroesophageal reflux disease. Limited dissection at the hiatus is one of the benefits of the procedure, but makes precise and accurate preoperative assessment of even small hiatal hernia critical. Retrospective cohort study of 136 patients having undergone both endoscopy (EGD) and videoesophagography followed by operative assessment for hiatal hernia during magnetic sphincter augmentation. The objective of the study is to determine which preoperative modality more accurately predicts operative hiatal hernia size. Videoesophagography underestimated operative measurement by 0.37 ± 1.41 cm ( P = 0.003) and was less accurate in predicting intraoperative hiatal hernia size than EGD on linear regression analysis (β -0.729, SE 0.057, P < 0.001). EGD was less accurate at predicting hiatal hernia size as patient age increased (β -0.018, SE 0.007, P = 0.014) and with larger hernias (β -0.615, standard error (SE) 0.067, P < 0.001); however, endoscopic measurements did not differ significantly from intraoperative measurements (0.93 ± 1.23 cm vs 1.12 ± 1.43 cm, P = 0.12). EGD better predicts the size of small hiatal hernia measured during subsequent laparoscopic surgery.
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Ushimaru, Yuki, Kiyokazu Nakajima, Tsuyoshi Takahashi, Makoto Yamasaki, Masaki Mori, and Yuichiro Doki. "Occult Hiatal Hernia in Achalasia Patients: Its Incidence and Treatment Options." Digestive Surgery 36, no. 5 (October 10, 2018): 418–25. http://dx.doi.org/10.1159/000491707.
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Background: Achalasia patients occasionally coexist with esophageal hiatal hernias. The purpose of this study was to clarify the incidence and clinical features of achalasia cases concomitant with hiatal hernia, and to investigate whether our surgical technique was appropriate. Methods: Consecutive achalasia patients who underwent laparoscopic Heller myotomy with Dor fundoplication (LHD) were extracted from the prospectively compiled surgical database, and the perioperative outcomes and the presence rate of hiatal hernia were obtained. Results: We enrolled 58 patients with LHD from 2005 to 2016. Hiatal hernia was seen in 12 patients (20.7%) without preoperative diagnosis. There was no significant difference in preoperative symptoms between patients with and without hiatal hernia. In 6 patients with trivial hiatal hernia, we did not perform hernia repair. In 6 cases with large hiatal hernia, cruroplasty was added. No serious postoperative complications were observed in either of the groups and no patient required reoperation. Symptoms were improved in all patients postoperatively. Residual symptoms were successfully treated with medication, and no patient experienced severe reflux esophagitis or required hiatal hernia repair after surgery. Conclusion: Hiatal hernia was found in 20.7% of patients who received surgical treatment for achalasia, but no cases were diagnosed prior to surgery.
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Akhmatov, Akhmat M., Ivan S. Tarbaev, and Dmitrij I. Vasilevsky. "The history of development of hiatal hernias’ surgery." Pediatrician (St. Petersburg) 9, no. 3 (December 15, 2018): 77–80. http://dx.doi.org/10.17816/ped9377-80.
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The article presents the main stages of formation of modern ideas about hiatal hernias as one of the most frequent variants of visceral anatomy’s impairment. The history of development of hiatal hearnias’ surgery is presented from the moment of its birth to the present time. According to modern ideas hiatal hernias are considered to be a chronic recurrent disease when abdominal part of esophagus, part of stomach or other internal is dislocated into a mediastenum and hernia ring is presented by esophageal hiatus. During the long time hiatal hernias were considered to be just the anatomical phenomenon. It’s known that Angello Soresi was the first American surgeon who performed an operation on hiatal hernia in 1919. A lot of original techniques of hiatal hernias’ surgery were devised in 1950. Operations developed by American surgeon – Ronald Belsey and European clinicians – Philip Allison and others became mostly widespread. During the next 10 years (1960-1970) techniques with obligatory antireflux component were offered. Most effective and popular operations which are used nowadays are ones that were developed by Rudolph Nissen, Andre Toupet, Lucius Hill and others. New stage of hiatal hernias` surgery started at 90’s of the XX century – the century of laparoscopic technologies’ wide application into clinical practice. Bernard Dallemagen performed such an operation for the first time in 1991. V.A. Kubyshkin, V.D. Fedorov and many others became the ideologists and pioneers of laparoscopic surgery of haital hernias in Russia. Application of new treatment methods and standardization of most surgical techniques permitted to increase efficiency and safety of hiatal hernias’ surgery.
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Grząsiak, Oliwia, Adam Durczyński, Piotr Hogendorf, Alicja Majos, and Janusz Strzelczyk. "Tension-Free Hiatal Hernia Repair Using Ligamentum Teres in Paraoesophageal Hernia Treatment." Polish Journal of Surgery 95, no. 4 (November 18, 2022): 1–5. http://dx.doi.org/10.5604/01.3001.0016.0958.
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Abstract Introduction Type II and III (paraoesophageal and mixed) hiatal hernia treatment remains a technically difficult procedure carrying a risk of complications and recurrence as high as 40%. Using synthetic meshes entails possible serious complications; efficacy of biologic materials remains unclear and requires further research. Aim The aim of the article was to present the centre’s experience of type II and III large hiatal hernia treatment using the ligamentum teres and to draw attention to potential benefits of conducted procedures. Material and Methods The study enrolled 6 patients: 3 women and 3 men aged 37-58 with radiologically and endoscopically confirmed large paraoesophageal hernias. The patients underwent Nissen fundoplication and hiatal hernia repair using the ligamentum teres. The patients were followed up for six months with subsequent radiological and endoscopic assessment. Results During the six-month follow-up no clinical or radiological characteristics of hiatal hernia recurrence were observed in the patients. Two patients reported symptoms of dysphagia; mortality was 0%. Conclusions Hiatal hernia repair using the vascularized ligamentum teres may constitute an effective and safe method of large hiatal hernia repair.
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Watson, Thomas J., and Kathryn M. Ziegler. "The Pathogenesis of Hiatal Hernia." Foregut: The Journal of the American Foregut Society 2, no. 1 (March 2022): 36–43. http://dx.doi.org/10.1177/26345161221083020.
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Hiatal hernia is a common malady and an important contributor to the pathophysiology of gastroesophageal reflux disease (GERD). Hiatal herniation is thought to result from any of several causes including transdiaphragmatic pressure gradients; congenital or acquired abnormalities in the cellular structure, biochemical composition, or geometry of the hiatus; or esophageal shortening due to fibrosis. Since no single theory explains the development of a hiatal hernia in all cases, or the reasons behind progression of some and not others, the pathogenesis of hiatal herniation likely is multifactorial and varies between individuals. A comprehension of the factors leading to hiatal hernia formation is important to their prevention and correction as well as to an understanding of the pathogenesis of GERD.
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Rozenfel'd, Igor I. "Current issues of surgical treatment of large and giant hiatal hernias." Medical Journal of the Russian Federation 27, no. 3 (May 15, 2021): 291–98. http://dx.doi.org/10.17816/0869-2106-2021-27-3-291-298.
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This work analyzes Russian and international literature sources that discuss the surgical intervention results for large and giant hiatal hernias. To date, there is no uniform classification of hiatal hernias by the size of the hernial defect. The classifications and algorithms for choosing the plastic method proposed by various authors provide no convincing evidence base. Although there are many methods for surgically correcting hiatal hernia, clear indications for their implementation have not been developed. The postoperative complications and relapses of the disease after surgery represent an unresolved issue. The laparoscopic approach for large and giant hiatal hernias is preferable to open surgery. However, it can lead to serious intra- and postoperative complications, especially in emergency cases. Alloplasty provides clinical improvement and an increase in the quality of life of patients, but has a relatively high risk of recurrence. To date, the treatment of hiatal hernias involves using various prosthetic materials, and their advantages and disadvantages are described in this article. Thus, the search for optimal surgical techniques to treat large and giant hiatal hernias continues.
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Abbood, Ali, Hareer Al Salihi, Jorge Parellada, Mario Madruga, and S. J. Carlan. "A Large Intrathoracic Hiatal Hernia as a Cause of Complete Heart Block." Case Reports in Cardiology 2021 (July 9, 2021): 1–4. http://dx.doi.org/10.1155/2021/6697016.
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Hiatal hernia is a not uncommon anatomic disorder resulting in portions of the bowel occupying space in the thoracic cavity. There are a number of antecedent risk factors including obesity but not hiatal hernias resulting in symptoms. When symptoms do occur, they can include chest pain, nausea, abdominal pain, and gastroesophageal reflux. Cardiac arrhythmias have also been reported as associated conditions resulting from a hiatal hernia. To date, however, a complete heart block secondary to a hiatal hernia has not been reported. An 88-year-old female with a history of GERD (gastroesophageal reflux disease) was found to have a large hiatal hernia at endoscopy after she presented to the emergency department with nausea and abdominal pain. Prior to her scheduled surgical repair, she developed symptomatic third degree heart block which resolved with nasogastric tube deflation of the gastric contents. After surgical repair of the hiatal hernia, she developed episodes of atrial fibrillation with rapid ventricular response and was started on diltiazem. She eventually converted back to normal sinus rhythm and remained dysrhythmia free. In addition to other known arrhythmias associated with hiatal hernia, a complete heart block can also be seen. Acute management requires deflation of the chest occupying hernia. This appears to be the one of the first reported cases of complete heart block caused by hiatal hernia.
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Arcerito, Massimo, Eric Changchien, Monica Falcon, Mauricio A. Parga, Oscar Bernal, and John T. Moon. "Robotic Fundoplication for Gastroesophageal Reflux Disease and Hiatal Hernia: Initial Experience and Outcome." American Surgeon 84, no. 12 (December 2018): 1945–50. http://dx.doi.org/10.1177/000313481808401242.
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Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). The mean age of the patients was 58 years. Biosynthetic mesh was used in 28 patients with paraesophageal hernia. The mean operative time was 115 minutes (90–132) in the sliding hiatal hernia group, whereas it was 200 minutes (180–210) in the paraesophageal hiatal hernia group. The mean hospital stay was 36 hours (24–96). Eight patients experienced mild dysphagia which resolved after four weeks. No postoperative dysphagia was recorded at 30-month median follow-up. We experienced one recurrence in the sliding hernia group and two recurrences in the paraesophageal hernia group, with two patients treated robotically. Robotic fundoplication in treating sliding hiatal hernia is feasible and safe but is more challenging in the large paraesophageal group. Improved patient outcomes hinge on the operative technique used and increasing surgeon experience. The increased dexterity that robotic surgery affords enables the esophageal surgeon to more adeptly apply the traditional principles of laparoscopic fundoplication.
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Patoulias, Dimitrios, Maria Kalogirou, Thomas Feidantsis, Ignatios Kallergis, and Ioannis Patoulias. "Paraesophageal Hernia as a Cause of Chronic Asymptomatic Anemia in a 6 Years Old Boy; Case Report and Review of the Literature." Acta Medica (Hradec Kralove, Czech Republic) 60, no. 2 (2017): 76–81. http://dx.doi.org/10.14712/18059694.2017.97.
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Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Four types are identified: type Ι or sliding hiatal hernia, type II or paraesophageal hernia (PEH), type III or mixed hernia and type IV. Congenital type II esophageal hiatal hernia is caused by a remaining gap after the formation of pleuroperitoneal membrane. We present a case of a six years old boy admitted to our department, appearing with asymptomatic anemia, who was incidentally diagnosed with Type II esophageal hiatal hernia. After diagnostic investigation, the prolapsing stomach pouch was reduced, the hernia sac was excised, the crura of diaphragm were converged and a total fundoplication was performed, via open method. The patient had an uncomplicated postoperative period. We conclude that: 1) esophageal hiatal hernia should be included within diagnostic approach of a child with chronic non-hereditary anemia, 2) after a Type II esophageal hiatal hernia is diagnosed, a hernia repair surgery is indicated in short time, due to the severity of possible complications and 3) through the performance of total fundoplication, it is secured that the subdiaphragmatic abdominal part of esophagus will be retained, preventing the development of post-operative gastroesophageal reflux disease.
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Moore, Clint J., Devan A. Conley, Cristóbal S. Berry-Cabán, and Ryan P. Flanagan. "Severe Hiatal Hernia as a Cause of Failure to Thrive Discovered by Transthoracic Echocardiogram." Case Reports in Pediatrics 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/3821470.
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A newborn infant with failure to thrive presented for murmur evaluation on day of life three due to a harsh 3/6 murmur. During the evaluation, a retrocardiac fluid filled mass was seen by transthoracic echocardiogram. The infant was also found to have a ventricular septal defect and partial anomalous pulmonary venous return. Eventually, a large hiatal hernia was diagnosed on subsequent imaging. The infant ultimately underwent surgical repair of the hiatal hernia at a tertiary care facility. Hiatal hernias have been noted as incidental extracardiac findings in adults, but no previous literature has documented hiatal hernias as incidental findings in the pediatric population.
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Sahin, Cem, Fatih Akın, Nesat Cullu, Burak Özseker, İsmail Kirli, and İbrahim Altun. "A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea." Case Reports in Cardiology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/546395.
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Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea.
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Zhang, Xiaobin, Yifeng Sun, and Zhigang Li. "PS01.068: LAPAROSCOPIC MANAGEMENT OF LARGE HIATAL HERNIA WITH SIMPLY SUTURE CLOSURE." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 68–69. http://dx.doi.org/10.1093/dote/doy089.ps01.068.
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Abstract Background Laparoscopic approach has been demonstrated as safe and effective surgical access in approaching gastroesophageal reflux disease (GERD) and hiatal hernia repair. Several studies have proposed for repairing that hiatal hernia, especially large hiatus with mesh reinforcement. The objective of our study was to evaluate the effect of simple suture closure in management of large hiatus hernia (> 5 cm). Methods Between September 2012 to February 2018, 32 patients who underwent laparoscopic large hiatal hernia (> 5 cms hernia defect) repair by simply suture closure were included in our study. Different anti-reflux surgery was performed according to esophageal function examination. Peri-operative data and complications were retrospectively reviewed. 30-months complications and symptom control at 1 year were assessed by GERD-HRQL score and PPI use. Results 29 cases were performed completely with laparoscopy, with 3 cases with da Vinci Surgical System and 1 case through left thoracotomy. Hiatal hernia of all patients was repaired by simply suture closure, 24 cases were successfully operated with Nissen, 5 cases with, 2 cases with Dor and 1 case with Belsey Mark IV Fundoplication. At 3 months postoperatively follow-up, 94% of patients were off anti-reflux medications, abdominal pain occurred in 8.8(3 cases) of patients, mild dysphagia occurred in 1 patient, and 2 patients with severe dysphagia required dilator therapy. Two patients (5.9%) developed recurrence on routine follow up. Conclusion Our study showed simply suture closure was a feasible technique for repair large hiatus hernia. The advantages between laparoscopic mesh cruroplasty and simply suture closure for large hiatal hernia repair, randomised controlled trials are needed. Disclosure All authors have declared no conflicts of interest.
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Tarasov, T. A., and L. Y. Markulan. "Paraesophageal hernia: the state of the problem and controversial issues. Review." General Surgery, no. 2 (December 30, 2022): 83–96. http://dx.doi.org/10.30978/gs-2022-2-83.
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The literature review focuses on the controversial issues regarding the treatment of paraesophageal hernia. The limitations of the current classification of hiatal hernias are highlighted. It is irrelevant and does not meet clinical needs. Objective criteria for its improvement are proposed. Data on the prevalence and course of hiatal hernias are given. Their pathogenetic factors and diagnostic methods are underlined. Considerable emphasis is placed on the paraesophageal hernia treatment strategies in patients with an asymptomatic and mildly symptomatic clinical course of the disease. Arguments are presented in favour of both wait‑and‑see tactics and planned hernioplasty. The choice of hernioplasty technique, especially in the case of giant hernias, the feasibility and indications for the use of mesh implants depending on their shape and composition, and the potential complications of allogenioplasty are the main topics for discussion. The problem of selecting a fundoplication method is addressed while weighing the advantages and potential side effects of employing various fundoplication modifications. The effects of correcting a short esophagus and eliminating the axial pressure on the esophageal hiatus are thoroughly evaluated, as these conditions increase the risk of hernia recurrence.
The authors concluded that there are many controversial issues in the treatment of paraesophageal hernia. A consensus is needed on the classification of paraesophageal hernias, which would meet the urgent needs of choosing the method of operative delivery, and, in particular, the definition of the concepts of «large hernia» and «giant hernia.» Further research is required on issues such as the indications for operative treatment of paraesophageal hernias, especially in the case of asymptomatic large hernias and incarcerated hernias; the feasibility of using implants for plastic surgery of the esophageal hiatus; the choice of a fundoplication method; the diagnosis and correction of a short esophagus; and methodology for evaluating long‑term treatment outcomes.
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Celeste, Francis, I. Made Yudi Mahardika, and Wifanto Saditya Jeo. "Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report." Intisari Sains Medis 11, no. 3 (December 1, 2020): 1298–301. http://dx.doi.org/10.15562/ism.v11i3.729.
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Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the mediastinum through the esophageal hiatus of the diaphragm.There are two main classifications, sliding hernias and paraesophageal hernias. This case study aims to evaluate the successful hiatal hernia repair with Nissen fundoplication by a laparoscopic approach.Case Presentation: We present a case of a 60-year-old male who presented with recurrent abdominal discomfort 6 months prior to the consultation. This was accompanied by loose stools, bloating, nausea, and vomiting. An initial diagnosis of Gastroesophageal Reflux Disease (GERD) was made. Conservative treatment was initiated with limited success. Endoscopy was then performed, revealing a hiatal hernia. Surgical intervention was then chosen as a therapeutic option via a laparoscopic approach and additional Nissen fundoplication with favorable outcomes.Conclusion: Symptomatic paraesophageal hernias are indicated for surgical repair.Paraesophageal hernias can be repaired transthoracically and transabdominal. Repairs via the transabdominal route can be performed with an open approach or laparoscopically, with the laparoscopic approach suggesting lower mortality and morbidity. Nissen fundoplication has been proven as an effective measure in GERD's control and in maintaining an intra-abdominal location of the gastroesophageal junction (GEJ).
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Endzinas, Žilvinas, Jelena Jončiauskienė, Antanas Mickevičius, and Mindaugas Kiudelis. "Hiatal hernia recurrence after laparoscopic fundoplication." Medicina 43, no. 1 (December 23, 2006): 27. http://dx.doi.org/10.3390/medicina43010003.
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Objectives. To determine the influence of hiatal hernia size and the laparoscopic fundoplication technique on the rate of hernia recurrence. Patients and methods. The preoperative, operative, and postoperative observational data of 381 patients operated on at the Department of Surgery of Kaunas University of Medicine during the period of 1998–2004 for hiatal hernia complicated with gastroesophageal reflux were analyzed. The surgery technique (Nissen or Toupet operation) was chosen independently of the hernia size. The radiological investigation of the esophagus–stomach using barium contrast as well as esophagogastroduodenoscopy and biopsy was performed for all patients before the surgery. The subjective and objective assessment of the patients’ health status was investigated before and no less than 12 months after surgery. If the disease symptoms remained or new ones (i.e. pain behind the sternum, dysphagia, etc.) occurred after surgery, the hernia recurrence was suspected. The radiological investigation of the esophagus–stomach using barium contrast, as well as esophagogastroduodenoscopy and biopsy were performed at the consultative outpatient clinic. The hernia recurrence was confirmed after performing these two investigations. When analyzing the results, the patients were divided into two groups: Group 1 – patients with small hiatal hernia (grade 1 and 2 hernia according to radiological classification), Group 2 – patients with large hiatal hernia (grade 3 and 4 hernia according to radiological classification). Results. A total of 272 (71.4%) patients had small hiatal hernia, and 109 (28.6%) patients had large ones. Hernia recurrence was diagnosed in 7 (2.58%) patients in Group 1, while in Group 2, 11 (10.1%) patients had hernia recurrence (P<0.05). Laparoscopic Nissen fundoplication was performed in 287 (75.4%) patients, after which 14 (4.98%) patients had hernia recurrence, while Toupet fundoplication was performed in 94 (24.6%) patients, after which 4 (4.3%) patients had hernia recurrence (P>0.05). Conclusions. The recurrence rate of hiatal hernia after laparoscopic fundoplications is significantly higher in patients with large hernias (grade 3 and 4 according to radiological classification). The surgery technique (Nissen or Toupet fundoplication) was not a significant factor affecting the recurrence rate of hiatal hernia.
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Belafsky, Peter C., Gregory N. Postma, and James A. Koufman. "Hiatal Hernia." Ear, Nose & Throat Journal 81, no. 8 (August 2002): 502. http://dx.doi.org/10.1177/014556130208100807.
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Johnson, David A., and W. Kirkland Ruffin. "Hiatal Hernia." Gastrointestinal Endoscopy Clinics of North America 6, no. 3 (July 1996): 641–66. http://dx.doi.org/10.1016/s1052-5157(18)30359-3.
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Mittal, Ravinder K. "Hiatal Hernia." American Journal of Medicine 103, no. 5 (November 1997): 33S—39S. http://dx.doi.org/10.1016/s0002-9343(97)00318-5.
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Castelijns, B., J. E. H. Ponten, M. C. G. Van de Poll, S. W. Nienhuijs, J. F. Smulders, Z. W. Hu, J. M. Wu, et al. "Hiatal Hernia." Hernia 19, S1 (April 2015): S13—S17. http://dx.doi.org/10.1007/bf03355320.
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Hefler, Joshua. "Case report: Type IV paraesophageal hernia." University of Ottawa Journal of Medicine 5, no. 1 (May 22, 2015): 36–39. http://dx.doi.org/10.18192/uojm.v5i1.1278.
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This case report is about a 43 year old man, who presented with a large paraesophageal hiatal hernia. Hiatal hernias are common and often asymptomatic. However, this patient’s hernia was caused by a large defect in his diaphragm, into which his stomach, multiple loops of small bowel and even part of his colon had herniated, causing recurrent gastric obstruction. While this is a condition that develops slowly, over time in most patients, this case of hiatal hernia likely results from a congenital defect, given his relatively young age, the size of the defect and his associated anatomical abnormalities. This report details his presentation and surgical repair, complemented with corresponding images.
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Kyeong Kim, Mi, Junoik Shin, Jeong-Hyun Choi, and Hee Yong Kang. "Low-dose combined spinal-epidural anesthesia for a patient with a giant hiatal hernia who underwent urological surgery." Journal of International Medical Research 46, no. 10 (August 29, 2018): 4354–59. http://dx.doi.org/10.1177/0300060518793800.
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A hiatal hernia refers to herniation of the abdominal organs through the esophageal hiatus of the diaphragm. A giant hiatal hernia affects digestive and cardiopulmonary function by compressing the organs. We report a patient who had low-dose combined spinal and epidural anesthesia (CSEA) for safe and effective anesthesia for conservative treatment of a giant hiatal hernia. An 84-year-old woman who had a giant hiatal hernia was scheduled for ureteroscopic removal of a ureteral stone. CSEA was performed at the L4 to L5 lumbar interspace and an epidural catheter tip was placed 5 cm cephalad from the inserted level. The T12 block was checked after 10 minutes of intrathecal injection of 6 mg of 0.5% bupivacaine. The T10 block was checked after additional injection of 80 mg of 2% lidocaine through the epidural catheter. During anesthesia and surgery, the patient's vital signs remained stable and the operation was completed within 1 hour without any problems. In conclusion, low-dose CSEA may be safely used without any cardiopulmonary and gastrointestinal problems in patients with a giant hiatal hernia undergoing urological surgery.
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Klimashevich, Alexandr V., Valery I. Nikolsky, B. Faraj, and Yaroslav E. Feoktistov. "Method of treatment of giant hernias of the esophageal opening of the diaphragm. Clinical case." Hirurg (Surgeon), no. 5-6 (March 1, 2021): 21–25. http://dx.doi.org/10.33920/med-15-2103-03.
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The treatment of giant hiatal hernias with the need to perform a cruroplasty is an urgent problem. This article describes a new method of treating a hernia of the esophageal opening of the diaphragm with laparoscopic access, using a combined xenopericard endoprosthesis as an implant. A clinical observation was carried out. Conclusion: this observation indicates the possibility of using a combined implant a xenopericard band for cruroplasty with giant hernia hiatal, which creates a strong anti-adhesive frame hiatal.
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Rosenfeld, I. I., D. L. Chilikina, S. R. Ivanov, V. A. Tsypnyatov, and S. V. Ershova. "A review of modern methods for operative treatment of diaphragmatic hernias." Siberian Medical Review, no. 3 (2021): 44–49. http://dx.doi.org/10.20333/25000136-2021-3-44-49.
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Hiatal hernia amounts to 90% of all diaphragmatic hernias. According to data obtained from large-scale epidemiological studies in Europe and the USA, esophageal hernias may be revealed in 30-40% of the population, 15% among which require surgical treatment. The occurrence rate equals 91% for small hernias, 6% for large hernias and 3% for giant hernias. The article presents a review of literature dated 2011-2020 and devoted to results of operative treatment of hiatal hernia of different sizes. The search for the publications was performed in the following databases: Web of Science, Scopus, PubMed, e-library, Ulrich's Periodicals Directory, Google Scholar and AGRIS. There is a large number of methods for surgical correction of diaphragmatic hernia. However, strict indications to their application have not been developed to the date. Alloplasty provides for improvement of the clinical picture and of the patients’ quality of life, but bears quite a high risk of recurrence. To this day, treatment of hiatal hernia frequently involves application of various prosthetic materials with their certain advantages and disadvantages. Therefore, the search for optimal surgical methods for treatment of diaphragmatic hernias of different sizes continues and requires further investigation.
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Rosenfeld, I. I. "Plastic for diaphragmal hernia." Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) 11, no. 5 (October 27, 2021): 66–72. http://dx.doi.org/10.20340/vmirvz.2021.5.clin.1.
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Aim. The article discusses the results of a study using a patented method of two-layer laparoscopic repair of large and giant hiatal hernias using a biocarbon implant in comparison with other surgical techniques.Materials and methods. 716 patients were divided into 3 study groups based on the area of the size of the esophageal hernia defect: group I (314 patients) – with small (less than 5 cm2) and medium (5–10 cm2) hiatal hernias, that is, up to 10 cm2, which hernioplasty was performed only by the method of posterior cruraphy; group II (323 patients) – with large hernias 10–20 cm2: subgroup 1 (92 patients) underwent posterior cruraphy, subgroup 2 (231 patients) – alloplasty. Depending on the alloplasty technique, subgroup 2, in turn, was divided: subgroup A (89 people) – hernioplasty with a polypropylene implant and subgroup B (142 people) – hernioplasty with a medical biocarbon construction. Study group III (79 patients) – patients with giant diaphragmatic hernias of more than 20 cm2 using alloplasty: subgroup A (29 people) – hernioplasty with a polypropylene implant and subgroup B (50 patients) – alloplasty with a medical biocarbon construction.Results. When comparing group I with subgroup 1 of group II, the following results were obtained. Statistically significant differences were found in the degrees and types of diaphragmatic hernias. The average age of patients and statistical differences for it were insignificant. When comparing subgroup 1 with subgroup 2 of group II, statistically insignificant differences were found in the degrees and types of hiatal hernias. The difference in the average age of patients was also statistically insignificant. The difference in the average age of patients was also statistically insignificant. When comparing subgroup A with subgroup B of group II, statistically insignificant differences were found among themselves in the degrees and types of hiatal hernias. When comparing subgroup 2 of group II with group III, the difference turned out to be statistically significant in the distribution of patients by types and degrees of diaphragmatic hernias. When comparing subgroup A with subgroup B of group III by degrees and types of hiatal hernias, statistically insignificant differences were revealed.Conclusion. Posterior cruraphia in small and medium diaphragmatic hernias had significant statistical differences in types and degrees compared to that in large hernias, as well as in the average area of the hernial defect. Posterior cruraphia with hernioplasty in large hiatal hernias did not differ statistically significantly according to any of the criteria. Plastic surgery with a polypropylene implant with alloplasty of a biocarbon implant for large hernias did not differ significantly according to any of the criteria. Hernioplasty for large hiatal hernias, when compared with giant hernias, differed significantly only in the degree and type, as well as in the area of the hernial defect. «Onlay» plastic surgery with a polypropylene implant with alloplasty of biocarbon structures for giant hernias did not differ significantly according to any of the criteria, except for gender distribution, which did not have significant fundamental significance, which made it possible to make a more correct comparison of the results of surgical interventions in these research subgroups.
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Kahrilas, P. J., S. Lin, J. Chen, and M. Manka. "The effect of hiatus hernia on gastro-oesophageal junction pressure." Gut 44, no. 4 (April 1, 1999): 476–82. http://dx.doi.org/10.1136/gut.44.4.476.
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BACKGROUNDHiatus hernia and lower oesophageal sphincter hypotension are often viewed as opposing hypotheses for gastro-oesophageal junction incompetence.AIMSTo examine the interaction between hiatus hernia and lower oesophageal sphincter hypotension.METHODSIn seven normal subjects and seven patients with hiatus hernia, the squamocolumnar junction and intragastric margin of the gastro-oesophageal junction were marked with endoscopically placed clips. Axial and radial characteristics of the gastro-oesophageal junction high pressure zone were mapped relative to the hiatus and clips during concurrent fluoroscopy and manometry. Responses to inspiration and abdominal compression were also analysed.RESULTSIn normal individuals the squamocolumnar junction was 0.5 cm below the hiatus and the gastro-oesophageal junction high pressure zone extended 1.1 cm distal to that. In those with hiatus hernia, the gastro-oesophageal junction high pressure zone had two discrete segments, one proximal to the squamocolumnar junction and one distal, attributable to the extrinsic compression within the hiatal canal. Inspiration and abdominal compression mainly augmented the distal one. Simulation of hernia reduction by algebraically summing the proximal segment pressures with the hiatal canal pressures restored normal maximal pressure, radial asymmetry, and dynamic responses of the gastro-oesophageal junction.CONCLUSIONSHiatus hernia reduces lower oesophageal sphincter pressure and alters its dynamic responsiveness by spatially separating pressure components derived from the intrinsic lower oesophageal sphincter and the extrinsic compression of the oesophagus within the hiatal canal.
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Pisoni, L., S. Del Magno, F. Cinti, M. Baron Toaldo, M. Joechler, and M. Pietra. "Combined surgical and endoscopic approach for the reduction of a congenital hiatal hernia in a cat: a case report." Veterinární Medicína 59, No. 3 (May 7, 2014): 150–56. http://dx.doi.org/10.17221/7385-vetmed.
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A case of surgical resolution of type I or “sliding” hiatal hernia is reported. A seven-month-old kitten was presented because of abdominal discomfort, accelerated breathing after eating and chronic vomiting. The clinical examination was unremarkable. Thoracic radiographs and gastroscopy led to the diagnosis of type I hiatal hernia. The surgical resolution consisted of hiatal plication, oesophagopexy and left-flank incisional gastropexy. All procedures were carried out using a 6 mm videoendoscope positioned in the stomach to evaluate the right oesophago-gastric junction reduction. One week after surgery there was a recurrence of symptoms and a second laparotomy was performed. During the second surgery additional hiatal plication was necessary and an oesophagopexy was repeated after dissection of the phrenico-oesophageal ligament. Moreover, a new incisional gastropexy was carried out after resolution of the first one. The cat recovered without complications and at one-year follow-up did show no signs related to the hiatal hernia. This communication reports on possible additional surgical techniques in cases of type I hiatal hernia and contributes to an understanding of the importance of oesophagopexy in cases of hiatus malformation.
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Khamid, Z. M., D. I. Vasilevskii, A. Yu Korol’kov, and S. G. Balandov. "Combined laparoscopic intervention for compression syndrome of the celiac trunk and hiatal hernia." Grekov's Bulletin of Surgery 179, no. 2 (June 29, 2020): 47–50. http://dx.doi.org/10.24884/0042-4625-2020-179-2-47-50.
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The OBJECTIVE was to present the results of surgical treatment of the patient with the combined pathology: celiac trunk compression syndrome and hiatal hernia. In the 63-year-old patient with chronic abdominal pain and dysphagia, a type III esophageal hiatus hernia and a celiac trunk compression syndrome were detected during the examination. The simultaneous operation was performed: laparoscopic decompression of the celiac trunk and laparoscopic removal of the hiatal hernia with fundoplication according to R. Nissen.
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Rozenfel'd, Igor I. "Plastic and cruroraphy for chiatal hernia." Consilium Medicum 23, no. 5 (2021): 453–56. http://dx.doi.org/10.26442/20751753.2021.5.200924.
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Aim. The article discusses the results of a study using a patented method of two-layer laparoscopic repair of large and giant hiatal hernias using a biocarbon implant in comparison with other surgical techniques. Materials and methods. 716 patients were divided into 3 study groups based on the area of the size of the esophageal hernia defect: group I (314 patients) – with small (less than 5 cm2) and medium (5–10 cm2) hiatal hernias, that is, up to 10 cm2, which hernioplasty was performed only by the method of posterior cruraphy; group II (323 patients) – with large hernias 10–20 cm2: subgroup 1 (92 patients) underwent posterior cruraphy, subgroup 2 (231 patients) – alloplasty. Depending on the alloplasty technique, subgroup 2, in turn, was divided: subgroup A (89 people) – hernioplasty with a polypropylene implant and subgroup B (142 people) – hernioplasty with a medical biocarbon construction. Study group III (79 patients) – patients with giant diaphragmatic hernias of more than 20 cm2 using alloplasty: subgroup A (29 people) – hernioplasty with a polypropylene implant and subgroup B (50 patients) – alloplasty with a medical biocarbon construction. Results. When comparing group I with subgroup 1 of group II, the following results were obtained. Statistically significant differences were found in the degrees and types of diaphragmatic hernias. The average age of patients and statistical differences for it were insignificant. When comparing subgroup 1 with subgroup 2 of group II, statistically insignificant differences were found in the degrees and types of hiatal hernias. The difference in the average age of patients was also statistically insignificant. The difference in the average age of patients was also statistically insignificant. When comparing subgroup A with subgroup B of group II, statistically insignificant differences were found among themselves in the degrees and types of hiatal hernias. When comparing subgroup 2 of group II with group III, the difference turned out to be statistically significant in the distribution of patients by types and degrees of diaphragmatic hernias. When comparing subgroup A with subgroup B of group III by degrees and types of hiatal hernias, statistically insignificant differences were revealed. Conclusion. Posterior cruraphia in small and medium diaphragmatic hernias had significant statistical differences in types and degrees compared to that in large hernias, as well as in the average area of the hernial defect. Posterior cruraphia with hernioplasty in large hiatal hernias did not differ statistically significantly according to any of the criteria. Plastic surgery with a polypropylene implant with alloplasty of a biocarbon implant for large hernias did not differ significantly according to any of the criteria. Hernioplasty for large hiatal hernias, when compared with giant hernias, differed significantly only in the degree and type, as well as in the area of the hernial defect. Onlay plastic surgery with a polypropylene implant with alloplasty of biocarbon structures for giant hernias did not differ significantly according to any of the criteria, except for gender distribution, which did not have significant fundamental significance, which made it possible to make a more correct comparison of the results of surgical interventions in these research subgroups.
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A, Naba Kumar Singh, and Bukke Ravindra Naik. "Rolling Non Reducible Intra Thoracic Gastric Hiatus Hernia causing Cardiogenic Shock." JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES 06, no. 3 (September 15, 2016): 103–5. http://dx.doi.org/10.58739/jcbs/v06i3.3.
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Para oesophageal (type II) hiatus hernia is a rare anatomical condition and is differentiated from the more common sibling (type I) hiatus hernia. Patients with clinical symptoms associated with para oesophageal hiatus hernia should undergo operative repair as there is a risk of developing life threatening complications in these hernia. We report a case of symptomatic rolling hiatal hernia in a middle aged wom-an, who developed a life threatening volvulus resulting in cardiogenic shock. Keywords: Non reducible gastric fundal and part of the greater curvature hernia, rolling hiatus hernia, para oesophageal hernia
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Janu, Peter, Ahmad Bassel Shughoury, Kumar Venkat, Daniel Hurwich, Tom Galouzis, James Siatras, Dennis Streeter, Kathleen Korman, George Mavrelis, and Peter Mavrelis. "Laparoscopic Hiatal Hernia Repair Followed by Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals." Surgical Innovation 26, no. 6 (August 20, 2019): 675–86. http://dx.doi.org/10.1177/1553350619869449.
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The TIF (transoral incisionless fundoplication) 2.0 procedure is indicated for patients with a hiatal hernia less than 2 cm. Many patients with gastroesophageal reflux disease (GERD) require hiatal hernia repair. This study examined the safety and efficacy when repairing defects in 2 anatomical structures (hiatus and lower esophageal sphincter) in a concomitant set of procedures in patients with hiatal hernias between 2 and 5 cm. Methods. Prospective data were collected from 99 patients who underwent hiatal hernia repair followed immediately by the TIF procedure (HH + -TIF). GERD-HRQL (Health-Related Quality of Life), RSI (Reflux Symptom Index), and GERSS (Gastroesophageal Reflux Symptom Score) questionnaires were administered before the procedure and mailed at 6 and 12 months. Results. Ninety-nine patients were enrolled, and all were symptomatic on PPI medications with hiatal hernias between 2 and 5 cm. Overall baseline GERD-HRQL scores indicated daily bothersome symptoms. At 12-month follow-up, median GERD-HRQL scores improved by 17 points, indicating that subjects had no bothersome symptoms. The median GERSS scores decreased from 25.0 at baseline to 1.0 and 90% of subjects reported having effective symptom control (score <18) at 12 months. Seventy-seven percent of subjects reported effective control of laryngopharyngeal reflux (LPR) symptoms at 12 months with an RSI score of 13 or less. At 12 months, 74% of subjects reported that they were not using proton pump inhibitors. All measures were statistically improved at P < .05. There were no adverse effects reported. Conclusion. HH + TIF provides significant symptom control for heartburn and regurgitation with no long-term dysphagia or gas bloat normally associated with traditional antireflux procedures. Most patients reported durable symptom control and satisfaction with health condition at 12 months.
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Tossier, Céline, Clairelyne Dupin, Laurent Plantier, Julie Leger, Thomas Flament, Olivier Favelle, Thierry Lecomte, Patrice Diot, and Sylvain Marchand-Adam. "Hiatal hernia on thoracic computed tomography in pulmonary fibrosis." European Respiratory Journal 48, no. 3 (May 12, 2016): 833–42. http://dx.doi.org/10.1183/13993003.01796-2015.
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Gastro-oesophageal reflux has long been suspected of implication in the genesis and progression of idiopathic pulmonary fibrosis (IPF). We hypothesised that hiatal hernia may be more frequent in IPF than in other interstitial lung disease (ILD), and that hiatal hernia may be associated with more severe clinical characteristics in IPF.We retrospectively compared the prevalence of hiatal hernia on computed tomographic (CT) scans in 79 patients with IPF and 103 patients with other ILD (17 scleroderma, 54 other connective tissue diseases and 32 chronic hypersensitivity pneumonitis). In the IPF group, we compared the clinical, biological, functional, CT scan characteristics and mortality of patients with hiatal hernia (n=42) and without hiatal hernia (n=37).The prevalence of hiatal hernia on CT scan at IPF diagnosis was 53%, similar to ILD associated with scleroderma, but significantly higher than in the two other ILD groups. The size of the hiatal hernia was not linked to either fibrosis CT scan scores, or reduction in lung function in any group. Mortality from respiratory causes was significantly higher among IPF patients with hiatal hernia than among those without hiatal hernia (p=0.009).Hiatal hernia might have a specific role in IPF genesis, possibly due to pathological gastro-oesophageal reflux.
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Katz, Philip O., and Gaurav Ghosh. "How I Teach It: Endoscopic Evaluation of Hiatal Hernia." Foregut: The Journal of the American Foregut Society 2, no. 1 (March 2022): 79–81. http://dx.doi.org/10.1177/26345161221091190.
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Hiatal herniation, migration of the gastric cardia from the abdomen cephalad into the chest are commonly present in patients with esophageal symptoms in particular gastroesophageal reflux disease. Three of the four hernia types (sliding type 1 and type 2 or 3 paraesophageal) can be diagnosed by upper endoscopy. Though hernias can also be diagnosed by barium esophagram, computed tomography, and high-resolution manometry, upper endoscopy offers the best opportunity for the foregut physician to carefully assess the patient for hernia size and type, the presence of Cameron lesions in patients with occult anemia and to evaluate the hiatus (flap valve) fully by assessment of the Hill grade in retroflexion. Accurate description of the hiatus in the endoscopy report is invaluable in communication between gastroenterologist and surgeon managing patients with esophageal disease. This “How I teach it” (and video) offers an approach to assessment of the esophageal hiatus during the endoscopic examination.
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Fukumoto, Koji, Masaya Yamoto, Hiroshi Nouso, Masakatsu Kaneshiro, Mariko Koyama, Naoto Urushihara, and Hiromu Miyake. "Surgical Management of Hiatal Hernia in Children with Asplenia Syndrome." European Journal of Pediatric Surgery 27, no. 03 (September 8, 2016): 274–79. http://dx.doi.org/10.1055/s-0036-1592135.
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Purpose Patients with asplenia syndrome (AS) are likely to have upper gastrointestinal tract malformations such as hiatal hernia. This report discusses the treatment of such conditions. Methods Seventy-five patients with AS underwent initial palliation in our institution between 1997 and 2013. Of these, 10 patients had hiatal hernia. Of the patients with hiatal hernia, 6 had brachyesophagus and 7 had microgastria. Results Of the 10 patients with hiatal hernia, 9 underwent surgery in infancy (7 before Glenn operation, 2 after Glenn operation). Two underwent typical Toupet fundoplication, and the other 7 underwent atypical repair including reduction of the stomach. Two patients with atypical repair showed recurrence of hernia and required reoperation. Three patients required reoperation due to duodenal obstruction. Duodenal obstruction occurred due to preduodenal portal vein or abnormal vessels compressing the duodenum. Obstructive symptoms were not seen in any cases preoperatively. Conclusions In patients with hiatal hernia, typical fundoplication is often difficult because most have concomitant brachyesophagus, microgastria, and hypoplasia of the esophageal hiatus. However, we should at least reduce the stomach to the abdominal cavity as early as possible to increase thoracic cavity volume and allow good feeding. Increasing the volume of the thoracic cavity thus makes Glenn and Fontan circulations more stable. Duodenal obstruction secondary to vascular anomalies is also common, so the anatomy in the area near the duodenum should be evaluated pre- and intraoperatively.
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George, Dafnomilis, Pappas V. Apostolos, Panoutsopoulos Athanasios, Lagoudianakis E. Emmanuel, Koronakis E. Nikolaos, Panagiotopoulos Nikolaos, Seretis Charalampos, Karanikas George, and Manouras J. Andreas. "Struggling with a Gastric Volvulus Secondary to a Type IV Hiatal Hernia." Case Reports in Medicine 2010 (2010): 1–3. http://dx.doi.org/10.1155/2010/257497.
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Type IV hiatal hernias are characterized by herniation of the stomach along with associated viscera such as the spleen, colon, small bowel, and pancreas through the esophageal hiatus. They are relatively rare, representing only about 5%–7% of all hernias, and can be associated with severe complications. We report a 71-year-old veteran wrestler who presented to our department with a type IV paraesophageal hernia containing a gastric volvulus and treated successfully with emergency operation.
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Bjelovic, Milos, Tamara Babic, Dragan Gunjic, Milan Veselinovic, and Bratislav Spica. "Laparoscopic repair of hiatal hernias: Experience after 200 consecutive cases." Srpski arhiv za celokupno lekarstvo 142, no. 7-8 (2014): 424–30. http://dx.doi.org/10.2298/sarh1408424b.
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Introduction. Repair of hiatal hernias has been performed traditionally via open laparotomy or thoracotomy. Since first laparoscopic hiatal hernia repair in 1992, this method had a growing popularity and today it is the standard approach in experienced centers specialized for minimally invasive surgery. Objective. In the current study we present our experience after 200 consecutive laparoscopic hiatal hernia repairs. Methods. A retrospective cohort study included 200 patients who underwent elective laparoscopic hiatal hernia repair at the Department for Minimally Invasive Upper Digestive Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2004 to December 2013. Results. Hiatal hernia types included 108 (54%) patients with type I, 30 (15%) with type III, 62 (31%) with giant paraesophageal hernia, while 27 (13.5%) patients presented with a chronic gastric volvulus. There were a total of 154 (77%) Nissen fundoplications. In 26 (13%) cases Nissen procedure was combined with esophageal lengthening procedure (Collis-Nissen), and in 17 (8.5%) Toupet fundoplications was performed. Primary retroesophageal crural repair was performed in 164 (82%) cases, Cleveland Clinic Foundation suture modification in 27 (13.5%), 4 (2%) patients underwent synthetic mesh hiatoplasty, 1 (0.5%) primary repair reinforced with pledgets, and 4 (2%) autologous fascia lata graft reinforcement. Poor result with anatomic and symptomatic recurrence (indication for revisional surgery) was detected in 5 patients (2.7%). Conclusion. Based on the result analysis, we found that laparoscopic hiatal hernia repair was a technically challenging but feasible technique, associated with good to excellent postoperative outcomes comparable to the best open surgery series.
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Sutherland, Victoria, Imothy Kuwada, Keith Gersin, Connie Simms, and Dimitrios Stefanidis. "Impact of Bariatric Surgery on Hiatal Hernia Repair Outcomes." American Surgeon 82, no. 8 (August 2016): 743–47. http://dx.doi.org/10.1177/000313481608200835.
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Large hiatal hernias are notorious for their high recurrence rates after conventional repair. Recurrence rates have been described to be higher in obese patients due to increased intraabdominal pressure. We hypothesized that patients who undergo hiatal hernia repair (HHR) with bariatric surgery (BAR) will have a lower hernia recurrence rate when compared to patients who undergo HHR with fundoplication (FP) due to the decrease in intra-abdominal pressure observed with weight loss. This was an Institutional Review Board approved retrospective review. The outcomes of patients who underwent HHR+BAR as well as patients who had HHR+FP only from 2007 to 2014 were reviewed. Patients who had small hiatal hernias (<2 cm), underwent an anterior repair, or had gastropexy only were excluded. The primary outcome was hernia recurrence and reflux resolution. The outcomes of 58 patients who had HHR+BAR were compared with 30 patients with HHR+FP. Hernia recurrence rate for HHR+BAR was 12 per cent, whereas hernia recurrence rate for HHR+FP was 38 per cent ( P < 0.01). Reflux resolution for HHR+FP was 78 per cent, whereas reflux improvement rate for HHR+BAR was 84 per cent ( P = n.s.). Combining HHR with BAR leads to a lower hernia recurrence rate when compared to patients who undergo HHR with FP.
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Bratu, Matei Răzvan, Bogdan I. Diaconescu, Alexandru Th Ispas, Mircea Beuran, and Alexandru-Laurenţiu Chiotoroiu. "Anatomical landmarks in laparoscopic surgical treatment of hiatal hernia." Romanian Medical Journal 63, no. 4 (December 31, 2016): 280–85. http://dx.doi.org/10.37897/rmj.2016.4.3.
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Hiatal hernia of the adult is a benign pathology of the abdominal esophagus and has an increasing incidence because of the association with obesity. Hiatal hernia becomes clinical manifest when it presents gastroesophageal reflux disease, when it is voluminous or is incarcerated. If for gastroesophageal reflux disease there is an endoscopic treatment, for hiatal hernia the treatment is purely surgical. Open or laparoscopic, the objectives of the surgical treatment are the same as for any abdominal hernia. The local anatomy plays an important role for fulfilling the objectives. This study provides a detailed description of the regional anatomy of the gastroesophageal junction and of the esophageal hiatus of the diaphragm based on the laparoscopic procedures performed in the Emergency Clinical Hospital of Bucharest. There were evaluated the aspects and the relations of the anatomical structures and also the consistency (because the manipulation and traction is made with the help of the instruments). In conclusion, a deep understanding of the regional anatomy and variations facilitates a safe laparoscopic dissection of diaphragmatic hiatus and abdominal esophagus and helps the surgeon to avoid intraoperative accidents.
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LEUNG, ALEXANDER K. C. "Familial Hiatal Hernia." Pediatrics 80, no. 3 (September 1, 1987): 462. http://dx.doi.org/10.1542/peds.80.3.462.
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To the Editor.— Hubert and Toyama1 reported a 2-month-old infant and his mother with hiatal hernia at the age of 2 months and suggested that the condition is transmitted by an autosomal dominant gene. Unlike congenital diaphragmatic hernia, most reviews fail to mention the familial occurrence of gastroesophageal reflux or hiatal hernia. Crabb et al2 described a family in which eight members in three generations had gastroesophageal reflux. In 1984, I reported a 13-month-old girl with gross gastroesophageal reflux.3
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ABDULCHAKOVA, D. A., and R. A. ABDULKHAKOV. "Diagnostics of hernias of the diaphragm esophageal opening." Practical medicine 20, no. 2 (2022): 57–62. http://dx.doi.org/10.32000/2072-1757-2022-2-57-62.
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The purpose — to show the possibilities of the classical X-ray research method for the diagnosis of hernias of the diaphragm esophageal opening. Material and methods. A classical X-ray examination of 138 patients with hiatal hernia was performed. Initially, a study of the chest organs and posterior mediastinum was carried out. A contrast study of the esophagus and stomach with a barium suspension was carried out in a horizontal position of the patient on the back and on the stomach, as well as vertically. Results. Mostly axial hiatal hernias were diagnosed — in 134 patients (97.1%), including 42 (31.3%) with esophageal shortening due to scarring and 92 (68.6%) sliding hernias; signs of intussusception were revealed in 2 cases. In one patient, along with the esophageal shortening, 2 «niches» were identified due to ulceration, which were confirmed by endoscopy. Paraesophageal hernias were found in 4 cases (2.9%), in all four cases the hernias were fixed; in one case, a total hernia with a volvulus of the stomach was diagnosed. In case of 23 (17.1%) patientsaxial hiatal hernias were combined with esophageal or gastric cancer. X-ray findings were confirmed by upper GI endoscopy. Conclusion. The up-to-date, correctly performed X-ray examination made it possible not only to reveal a hiatal hernia, but also to determine its type, to study the function of the esophageal-gastric junction and the presence of complications.
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Reed, Benjamin L., Lawrence E. Tabone, Nova Szoka, and Salim Abunnaja. "Emergency Laparoscopic Repair of an Iatrogenic Gastric Perforation in a Hiatal Hernia following a Failed Endoscopic Closure." Case Reports in Surgery 2020 (March 25, 2020): 1–4. http://dx.doi.org/10.1155/2020/5060962.
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Iatrogenic gastrointestinal perforation is a rare, life-threatening complication of endoscopic procedures, which requires either endoscopic or surgical repair. We report the account of an 82-year-old woman with an iatrogenic gastric perforation of a hiatal hernia secondary to an endoscopic retrograde cholangiopancreatography (ERCP) procedure. Despite immediate recognition of the complication and endoscopic closure with through-the-scope (TTS) clips, the patient developed mediastinitis, peritonitis, and sepsis. She subsequently underwent an emergency laparoscopic hiatal hernia dissection and repair of the perforation with mediastinal and peritoneal washout. Given the patient’s age and the degree of insult, subdiaphragmatic anchoring with abdominal drain placement was performed, and the hiatus was left open for additional drainage. The use of a side-viewing duodenoscope with the presence of a large hiatal hernia contributed to the risk of gastric perforation. We conclude that performing endoscopic procedures in patients with a known hiatal hernia should be carefully undertaken. If a perforation in such patients occurs, laparoscopic repair of such complications is feasible as demonstrated in this case video.
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Lara Orozco, Ulises, Erik D. Alvarez Sores, Verónica E. Masabanda Celorio, and Sahid Vargas Paredes. "Bowel obstruction secondary to type IV hiatal hernia: a case report." International Journal of Research in Medical Sciences 10, no. 9 (August 29, 2022): 2016. http://dx.doi.org/10.18203/2320-6012.ijrms20222280.
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Hiatal hernias are classified into four types. Type 4 hernias are not limited to the stomach alone, but involve herniation of the omentum, colon, small intestine, peritoneum, pancreas, or spleen into the chest cavity. Account for less than 5% of all cases. The probability that a patient with a paraesophageal hernia will develop acute symptoms and require emergency surgery is 1.16% per year. We present a case of acute paraesophageal hiatal hernia repair in a patient who developed large bowel obstruction. An 82-year-old female was admitted to emergency room referring abdominal distension, intolerance to the oral intake, vomiting of fecal content, as well as impossibility to pass gas or evacuate. On physical evaluation with tachycardia and acute abdomen, laboratory studies showed leukocytosis, radiographic data of intestinal obstruction, and at the level of the left hemithorax, space occupation by the colon was evident. An emergency surgery was performed finding paraesophageal hernia with involvement of the stomach and transverse colon, and retrograde dilatation of the ascending and transverse colon with ischemic changes. The patient presented hemodynamic instability, so an extended right hemicolectomy was decided, with distal closure, ileostomy, and hiatal plasty performed. She was discharged on postoperative day four without complications. Type 4 hiatal hernia complicated with intestinal obstruction is a condition that carries high rates of morbidity and mortality, so early surgery is mandatory to avoid a fatal outcome for the patient. There are currently no clear guidelines regarding the management of acute complicated paraesophageal hernias.
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Kutur, Sanjana Reddy, and Mrudula Chandrupatla. "Hiatal Hernia: A Case Report." Indian Journal of Anatomy 7, no. 4 (2018): 449–51. http://dx.doi.org/10.21088/ija.2320.0022.7418.18.
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Miyagi, Hisayuki, Shohei Honda, Hiromi Hamada, Masashi Minato, Momoko Ara, and Akinobu Taketomi. "One-Stage Laparoscopic Surgery for Pulmonary Sequestration and Hiatal Hernia in a 2-Year-Old Girl." European Journal of Pediatric Surgery Reports 06, no. 01 (January 2018): e11-e14. http://dx.doi.org/10.1055/s-0037-1612611.
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AbstractWe herein report a case of one-stage laparoscopic surgery for extralobar pulmonary sequestration (EPS) and hiatal hernia. Our patient was a 2-year-old girl who was diagnosed as a mediastinal mass lesion. Postnatal computed tomography revealed that the mediastinal mass was an EPS. Two weeks after birth, the patient developed gastroesophageal reflux (GER), and esophagography showed a hiatal hernia. At 2 years of age, she underwent one-stage laparoscopic Nissen's fundoplication for GER with resection of the EPS in the posterior mediastinum. The sequestrated lung was grasped via the esophageal hiatus; three aberrant blood vessels were dissected to allow removal of the sequestration through the umbilical port site. The esophageal hiatus was repaired and Nissen's fundoplication was performed laparoscopically. The patient's postoperative course was uneventful, with no recurrence of GER symptoms for 1 year. We conclude that one-stage laparoscopic surgery is useful for patients with EPS and hiatal hernia.
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Lukanin, Dmitriy Vladimirovich, Grigory Vladimirovich Rodoman, Alexey Alexeevich Sokolov, and Marina Sergeevna Klimenko. "A case of wrong diagnosis of paraesophageal hernia in a patient with a white line hernia." Hirurg (Surgeon), no. 9-10 (October 1, 2021): 5–15. http://dx.doi.org/10.33920/med-15-2105-01.
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Among all the anatomical variants for the hiatal hernia development, a true paraesophageal hernia is the most rare. The clinical manifestations of this type of hiatal hernia are caused by the infringement of the diaphragmatic crus or by transient obstruction of the esophagus with the development of organic dysphagia. The leading method of instrumental diagnostics of this pathology is contrast x-ray study of the esophagus and stomach with functional tests. The article describes a clinical case of an incorrect interpretation of the symptoms of the disease and the results of EGD in favor of paraesophageal hernia in association with GERD in a patient with a large white line hernia under conditions of migration into the hernial sac of the stomach and duodenum.
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Lukanin, Dmitriy Vladimirovich, Grigory Vladimirovich Rodoman, Alexey Alexeevich Sokolov, and Marina Sergeevna Klimenko. "A case of wrong diagnosis of paraesophageal hernia in a patient with a white line hernia." Hirurg (Surgeon), no. 9-10 (October 1, 2021): 5–15. http://dx.doi.org/10.33920/med-15-2105-01.
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Among all the anatomical variants for the hiatal hernia development, a true paraesophageal hernia is the most rare. The clinical manifestations of this type of hiatal hernia are caused by the infringement of the diaphragmatic crus or by transient obstruction of the esophagus with the development of organic dysphagia. The leading method of instrumental diagnostics of this pathology is contrast x-ray study of the esophagus and stomach with functional tests. The article describes a clinical case of an incorrect interpretation of the symptoms of the disease and the results of EGD in favor of paraesophageal hernia in association with GERD in a patient with a large white line hernia under conditions of migration into the hernial sac of the stomach and duodenum.
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Balaji, Nagammapudur, Carl Bradbury, Stephanie Evans, and Vittal Rao. "PS01.073: HIATAL HERNIA—DIAGNOSIS AND RELEVANCE—THE CONUNDRUM CONTINUES…." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 69–70. http://dx.doi.org/10.1093/dote/doy089.ps01.073.
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Abstract Background Upper GI endoscopy and barium swallow are the commonly used diagnostic modalities and Oesophageal manometry of late has contributed to the diagnosis of hiatal hernias. It is known that there exist considerable limitations within each modality in the diagnosis of this seemingly common condition. Aims To assess the correlation between the commonly used investigations of Upper GI Endoscopy and Barium studies and selective use of Esophageal physiology studies in the diagnosis of hiatal hernias. Methods 92 patients who had both an Upper GI endoscopy and Barium swallow in a University hospital formed the study population. There was a subgroup of 29 patients who also underwent a manometry and pH study as a part of their workup. A mix of endoscopists (Physicians, GPs, Surgeons, Supervised trainees and Nurses) performed the upper GI endoscopies. The barium studies were performed by specialist radiographers based on a standard protocol. GI physiology studies were performed by a single GI physiologist with over 25 years of experience. Correlation was performed in varied combinations based on the presence/absence and the size of hernias on different investigations. Results 74% (68) of patients were diagnosed to have a hiatal hernia on endoscopy whereas only 55% of the same group had a hiatal hernia on Barium studies. Of the 29 patients who had all the 3 investigations a hiatal hernia was diagnosed in 82% on endoscopy, 34% on Barium swallow and 48% on High resolution manometry. Only 21% of patients had correlation between all 3 studies. 62 percent had correlation between any 2 modalities and 17% did not have any correlation between any of the diagnostic modalities. The correlation in-between studies was greater for the moderate to large hernias and least for the small/absent hernias. Conclusion There exists considerable variation between the commonly performed procedures for this relatively presumed common condition. There is a greater observed tendency to diagnose a hiatal hernias on endoscopies and less on barium swallows based on the above study. The gold standard for the diagnosis is debatable, considering known limitations based on criteria for diagnosis, dynamic of the Oesophagogastric junction and operator variability. Disclosure All authors have declared no conflicts of interest.
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Martinelo, Vanderlei, Fernando Augusto Mardiros Herbella, and Marco G. Patti. "High-resolution Manometry Findings in Patients with an Intrathoracic Stomach." American Surgeon 81, no. 4 (April 2015): 354–57. http://dx.doi.org/10.1177/000313481508100424.
Full textAbstract:
Intrathoracic stomach is a rare finding. The real value of the high-resolution manometry (HRM) in the preoperative evaluation of these patients has not yet being fully tested. This study aims to evaluate: 1) the HRM pattern of patients with an intrathoracic stomach; and 2) HRM findings as predictors for prosthetic reinforcement of the hiatus. We reviewed 33 patients (27 women, mean age 66 years) with an intrathoracic stomach who underwent HRM. Fifteen patients did the HRM as part of preoperative workup and were operated on in our institution. All patients were submitted to a laparoscopic Nissen fundoplication. HRM results show that the lower esophageal sphincter (LES) was transposed in all patients. Hiatal hernia was diagnosed in 21 (63%) patients. The length of the hernia was 4 ± 2 cm (range, 1 to 9 cm). LES oscillation was observed in 23 (69%) patients with a mean of 1 ± 0.4 cm (range, 0.4 to 2 cm). Hiatal mesh reinforcement was necessary in five (33%) of the operated patients. HRM findings did not predict hiatal mesh reinforcement. Our results show that: 1) HRM has a poor sensibility for hiatal hernia diagnosis; 2) half of the patients with an intrathoracic stomach have a normal HRM; and 3) HRM does not predict mesh hiatal hernia repair.
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Bechvaya, Georgy T., Akhmat M. Ahmatov, Dmitry I. Vasilevsky, and Vladislav V. Kovalik. "Causes of unsuccessful surgical treatment of hiatal hernia." Pediatrician (St. Petersburg) 11, no. 2 (June 8, 2020): 67–72. http://dx.doi.org/10.17816/ped11267-72.
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Hiatal hernia is the most common type of visceral anatomy disorder, observed in people under 30 years of age in 10%, older than 50 years in 60%. Four types of hiatal hernias (IIV) are distinguished by the variant of the disturbances in the relationship between the esophagus, stomach, and diaphragm. Indications for surgical treatment of hiatal hernias are gastroesophageal reflux or anatomical disorders, which have a risk of developing life-threatening conditions (obstruction or necrosis of the stomach). An unresolved problem in this part of surgery is the high rate of disease recurrence, reaching 1015 4060%. The subjective reasons for the unsatisfactory results of surgical treatment of this pathology include technical errors in performing interventions (insufficient mobilization of the esophagus, stomach, legs of the diaphragm, incomplete excision of the hernial sac) and flaws in perioperative support (insufficient analgesia, vomiting, cough). The objective factors of the repeated displacement of the abdominal organs into the chest are the large size of the hiatal opening (more than 5 cm in maximum dimension), the insufficient mechanical strength of the legs of the diaphragm (hypotrophy, fibrosis) and the shortening of the esophagus (reduction of the abdominal part length less than 5 cm). Each of the noted factors plays a own role, together determining the success or failure of the surgical intervention. Understanding the basic principles and unresolved issues in this field of surgery is a prerequisite for its further development.
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Di Francesco, Stefania, Mariano Matteo Lanna, Marcello Napolitano, Luciano Maestri, Stefano Faiola, Mariangela Rustico, and Enrico Ferrazzi. "A Case of Ultrasound Diagnosis of Fetal Hiatal Hernia in Late Third Trimester of Pregnancy." Case Reports in Obstetrics and Gynecology 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/194090.
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Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most commonly the stomach, through a physiological but overlax esophageal hiatus into the thoracic cavity. Prenatal diagnosis of this anomaly is unusual and only eight cases have been reported in the literature. In this paper we describe a case of congenital hiatal hernia that was suspected at ultrasound at 39 weeks’ gestation, on the basis of a cystic mass in the posterior mediastinum, juxtaposed to the vertebral body. Postnatal upper gastrointestinal tract series confirmed the prenatal diagnosis. Postnatal management was planned with no urgency. Hiatal hernia is not commonly considered in the differential diagnosis of fetal cystic chest anomalies. This rare case documents the importance of prenatal diagnosis of this anomaly for prenatal counseling and postnatal management.