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Best Practice & Research. Clinical... 2008Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum.... (Review)
Review
Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum. With the most common type (type I or sliding hiatus hernia) this is associated with laxity of the phrenooesophageal membrane and the gastric cardia herniates. Sliding hiatus hernia is readily diagnosed by barium swallow radiography, endoscopy, or manometry when greater than 2 cm in axial span. However, the mobility of the oesophagogastric junction precludes the reliable detection of more subtle disruption by endoscopy or radiography. Detecting lesser degrees of axial separation between the lower oesophageal sphincter and crural diaphragm can only be reliably accomplished with high-resolution manometry, a technique that permits real time localization of these oesophagogastric junction components without swallow or distention related artefact.
Topics: Diagnosis, Differential; Endoscopy, Gastrointestinal; Hernia, Hiatal; Humans; Manometry; Pressure; Radiography, Thoracic; Reproducibility of Results; Severity of Illness Index
PubMed: 18656819
DOI: 10.1016/j.bpg.2007.12.007 -
The European Respiratory Journal Nov 2020
Topics: Gastroesophageal Reflux; Hernia, Hiatal; Humans; Lung
PubMed: 32527737
DOI: 10.1183/13993003.01679-2020 -
British Medical Journal Jul 1960
Topics: Diaphragm; Hernia, Diaphragmatic; Hernia, Hiatal; Humans
PubMed: 13797067
DOI: 10.1136/bmj.2.5194.247 -
Postgraduate Medical Journal Jun 1952
Topics: Diaphragm; Hernia, Diaphragmatic; Hernia, Hiatal; Humans
PubMed: 14948680
DOI: 10.1136/pgmj.28.320.333 -
Proceedings of the Royal Society of... May 1952
Topics: Diaphragm; Hernia, Diaphragmatic; Hernia, Hiatal; Humans
PubMed: 14941832
DOI: No ID Found -
British Medical Journal Jul 1955
Topics: Diaphragm; Hernia, Diaphragmatic; Hernia, Hiatal; Humans
PubMed: 14389742
DOI: No ID Found -
Chirurgia (Bucharest, Romania : 1990) 2018Purpose/Aim: Paraesophageal hiatus hernias are seldom found, however the incidence is increasing accounting for 5-10% of all hiatal hernias. The aim of this review is to... (Review)
Review
Purpose/Aim: Paraesophageal hiatus hernias are seldom found, however the incidence is increasing accounting for 5-10% of all hiatal hernias. The aim of this review is to emphasize controversies in clinical presentation, essential workup investigations and highlight non-surgical and surgical management options. A PubMed literature search using the keywords "large or giant paraesophageal hernia", "hiatus or hiatal hernia", "laparoscopic surgery", "antireflux surgery", "mesh", "gastric volvulus" and "diaphragmatic hernia" published between 1998 until 2017 was conducted. Presenting symptoms are non-specific and can be erroneously attributed to various more common medical conditions. Significant complications as gastric volvulus and stomach necrosis, may occur and the obscured clinical presentation can be confusing for the clinician. Management options in the elective setting are controversial, and surgical repair cannot be easily justified for a minimally symptomatic condition, especially in an elderly and perhaps frail patient. However, in the era of laparoscopic surgery around the hiatus, reduced operative stress makes surgical repair appealing in the elective setting. Surgical matters as the adjunct of an antireflux procedure or not, the use of prosthetic mesh to reinforce the hiatus, gastropexy and the clinical importance of radiological or endoscopic recurrence are still under debate. The laparoscopic treatment of paraesophageal hiatus hernias is effective with low morbidity rates, offered in symptomatic patients and good operative risk asymptomatic individuals. More studies are needed to assess improvement suggestions, as the use of prosthetic mesh or gastropexy, regarding complications and recurrence risks.
Topics: Aged; Hernia, Hiatal; Humans; Laparoscopy; Necrosis; Stomach; Stomach Volvulus; Treatment Outcome
PubMed: 30596364
DOI: 10.21614/chirurgia.113.6.765 -
Polski Przeglad Chirurgiczny Nov 2022AbstractIntroductionType II and III (paraoesophageal and mixed) hiatal hernia treatment remains a technically difficult procedure carrying a risk of complications and...
AbstractIntroductionType 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.AimThe aim of the article was to present the centres 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 MethodsThe 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.ResultsDuring 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%.ConclusionsHiatal hernia repair using the vascularized ligamentum teres may constitute an effective and safe method of large hiatal hernia repair.
Topics: Male; Humans; Female; Hernia, Hiatal; Herniorrhaphy; Laparoscopy; Gastroesophageal Reflux; Fundoplication; Round Ligaments; Treatment Outcome; Recurrence
PubMed: 36808069
DOI: 10.5604/01.3001.0016.0958 -
Thoracic Surgery Clinics Nov 2019Paraesophageal hernia represents a complex surgical problem involving significant distortion of the anatomy and function of the esophagus, stomach, gastroesophageal... (Review)
Review
Paraesophageal hernia represents a complex surgical problem involving significant distortion of the anatomy and function of the esophagus, stomach, gastroesophageal junction, mediastinum, lungs, and heart. Surgeons operating in the area must have deep understanding of the normal anatomy and pathologic derangements in patients with paraesophageal hernias. This article describes the normal anatomy and anatomic abnormalities in application to the various approaches used in the surgical repair of a paraesophageal hernia.
Topics: Diaphragm; Endoscopy, Digestive System; Esophageal Sphincter, Lower; Esophagus; Hernia, Hiatal; Herniorrhaphy; Humans; Laparoscopy; Radiography; Stomach; Tomography, X-Ray Computed
PubMed: 31564392
DOI: 10.1016/j.thorsurg.2019.07.008 -
Advances in Respiratory Medicine 2019Dyspnoea is most often caused by disorders of the respiratory and/or cardiovascular systems. Much less often it is brought about by the displacement of abdominal organs...
Dyspnoea is most often caused by disorders of the respiratory and/or cardiovascular systems. Much less often it is brought about by the displacement of abdominal organs into the thoracic cage. Hiatal hernias may give rise to diagnostic difficulties, as both clinical and radiological symptoms suggest different disorders. Computed tomography is the method of choice when making a diagnosis. We have presented a series of 7 cases of giant hiatal hernias, each with a varying course of the disease, clinical symptoms, radiological features and prognoses. In two of the cases, the hernias were of a post-traumatic nature. Four cases of large diaphragmatic hernias were found in elderly patients (over 90 years old). An advanced age and numerous coexisting chronic diseases disqualified most of the patients from surgical treatment despite the hernias' large sizes. In only one case was fundoplication performed with a good end result. Two patients died, and an extensive hernia was the cause of one of the deaths. Upper gastrointestinal symptoms were present only in a few of the patients. An early diagnosis of giant hiatal hernia is crucial for the patients to undergo prompt corrective surgeries.
Topics: Aged, 80 and over; Fatal Outcome; Female; Hernia, Hiatal; Herniorrhaphy; Humans; Laparoscopy; Male
PubMed: 30830959
DOI: 10.5603/ARM.a2019.0009