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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Massive hiatal hernia is a lesion at risk of incarceration, volvulus, and obstruction. The true paraesophageal type is a very rare condition and probably often mistaken with end-stage slidind hernia. Furthermore reflux and oesophagitis are always possible. In this case report a small bowel loop was incarcerated with a massive hiatal hernia. This association was only possible because of the existence of an associated transverse mesocolis hernia giving way to the small bowel. An emergency operation was necessary. The need of surgical treatment of such lesions is stressed, if possible before acute complication, even if they are asymptomatic at the time of diagnostic, which is a quite common condition.
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PMID:[Pseudostriction of hiatal hernia. Apropos of a case with incarceration of the transverse mesocolon and small intestine]. 184 19

A boy with hiatus hernia following the repair of the left postero-lateral diaphragmatic hernia (Bochdalek's hernia) was reported. At the age of one month, the repair of Bochdalek hernia was performed with transabdominal approach. At that time the stomach was located in the normal position. Eight days after the repair he developed vomiting and hiatus hernia was revealed by barium esophagram. Antireflux surgery was required because there was no response to the conservative management for two months. Esophageal pH study and manometric study were very useful for the diagnosis of hiatus hernia or GER and the evaluation of antireflux surgery.
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PMID:Association of hiatus hernia with postero-lateral diaphragmatic hernia (Bochdalek's hernia). 193 48

The pathophysiology and treatment of herniations through the esophageal hiatus remain controversial. For the majority of patients with a sliding hiatal hernia, medical treatment is preferred. Antireflux surgical techniques are reserved for those who fail medical treatment or have specific complications. A paraesophageal hernia may be life-threatening and requires surgical correction when diagnosed. Definitive surgical treatment consists of reduction of the hernia, excision of the sac, and partial closure of the widened hiatus anterior to the esophagogastric junction. Temporary gastrostomy is also advisable. A few patients have mixtures of the two types of hernia, and only those with incompetence of the lower esophageal sphincter require an antireflux procedure.
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PMID:Diaphragmatic hiatal hernias. Recognizing and treating the major types. 197 84

Concurrent videofluoroscopy and manometry were used to analyze esophageal emptying during barium swallows in 22 patients with axial hiatal hernias and in 14 volunteers. Subjects were divided into three groups: (a) volunteers with maximal phrenic ampullary length less than 2 cm (controls); (b) patients or volunteers with maximal ampullary/hiatal hernia length greater than or equal to 2 cm that reduced between swallows (reducing-hernia group); and (c) patients with hernias that did not reduce between swallows. Complete esophageal emptying without retrograde flow was achieved in 86% of test swallows in the controls, 66% in the reducing-hernia group, and 32% in the nonreducing-hernia group (P less than 0.05). Impaired emptying in the reducing-hernia group was attributable to "late retrograde flow," whereby barium squirted retrograde from the hernia during emptying. Impaired emptying in the nonreducing-hernia group was attributable to "early retrograde flow" that occurred immediately after LES relaxation. The nonreducing-hernia group also had longer acid clearance times than the controls (P less than 0.05). We conclude that gastroesophageal junction competence is severely impaired in patients with nonreducing hiatal hernias, suggesting a mechanism whereby this subgroup of hiatal hernia is involved in the pathogenesis of reflux disease.
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PMID:Impairment of esophageal emptying with hiatal hernia. 199 83

Gastric volvulus is not a rare condition and 350 authentic cases have been documented in the adult population. Most often, gastric volvulus was associated with a large paraoesophageal hernia (40%). We report seven new cases of gastric volvulus: 5 were due to a large paraoesophageal hernia, 1 to mixed hiatus hernia, and 1 to a sliding hiatus hernia. We did not observe any cases of acute strangulation with gastric necrosis. The lesions were reversible in the three cases of acute and four cases of chronic gastric volvulus. Surgical treatment included gastric volvulus reduction and repair of hiatus hernia without gastric resection. Surgical treatment of paraoesophageal hiatus hernia is mandatory to reduce the incidence of gastric volvulus. The possibility of gastric volvulus with hiatus hernia must be recognized.
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PMID:[Gastric volvulus secondary to para-esophageal and sliding hiatal hernias]. 200 58

From 1975 to 1988 we studied and valued fourteen pediatric patients, treated in the Department of Pediatric Surgery at Children's Hospital La Paz, with the Childs-Phillips procedure by postoperative recurrent bowel obstruction. Ten newborn infants had the following diagnoses: intestinal atresia, 4; Bochdaleck hernia, 3; Hirschsprung disease, 2; intestinal rotation anomalies, 1. Four patients out of neonatal period had: hiatal hernia, 1; intussusception, 1; appendicitis, 2. Six patients had more than one episode of bowel obstruction. The follow-up was 6.5 years (range four months to 13 years), and no recurrent bowel obstruction occurred.
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PMID:[The efficacy of the Childs-Phillips mesenteric plication in intestinal obstruction]. 207 71

The author detected a traumatic prolapse of stomach into thorax cavity. The X-ray examination was made only after ultrasonography. Two days after the operation, which confirmed the sonographic finding, symptoms of ileus became evident. The following ultrasonographic finding proved to be very similar to that made before the operation. A relapse of the prolapse was assumed to have occurred, but was not confirmed by a new operation. Since the X-ray examination of the stomach two months after the operation revealed a hiatus hernia, the author is of the opinion that a sliding hernia may have been cause of the erroneous diagnosis of the prolapse relapse.
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PMID:[The reliability of ultrasonic diagnosis in diaphragmatic rupture]. 218 76

A case of Morgagni's hiatal hernia is presented. Because of clinical symptoms (dizziness and chest pain) the patient was referred to the Cardiology Department and the diagnosis was a casual finding. The hernia sac contained transverse colon, great omentum and round ligament. We comment on the mechanism, etiologic factors, diagnosis, and surgical treatment. The present case was treated by an abdominal approach.
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PMID:[Morgagni's hernia. A case report]. 222 53

This study was undertaken to clarify the incidence of hiatus hernia and the functional changes in the cardia of post-gastrectomy patients. One hundred and four post-gastrectomy patients and 399 non-gastrectomy patients were selected for endoscopic study, and the diagnosis of hiatus hernia was made by observing the shape of the cardia inside the stomach. A manometric study was also done on 12 patients with gastric carcinoma and 14 patients with gallstones. Hiatus hernia was observed in 37.5 per cent of the post-gastrectomy patients, this incidence being significantly higher than the 19.3 per cent of the non-gastrectomy patients (p less than 0.01). In the latter group alone the incidence of hernia steadily increased with advancing age. In the post-gastrectomy patients, reflux esophagitis and heartburn were observed in 20.2 per cent and 27.9 per cent, respectively. These incidences tended to be higher in the patients with hernia but there were no significant differences. The manometric study revealed that lower esophageal sphincter pressure was significantly decreased after gastrectomy, but not after cholecystectomy.
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PMID:Endoscopic and manometric study of the cardia in post-gastrectomy patients. 230 88

Patients with an uncomplicated sliding hiatal hernia frequently experience dysphagia. The present study shows, using video barium contrast esophagograms, that the cause of dysphagia in 60% of these patients is an obstruction to the passage of the swallowed bolus by diaphragmatic impingement on the herniated stomach. Manometrically this was reflected by a double-hump high pressure zone (HPZ) at the gastroesophageal junction, and specifically to the length and amplitude of the distal HPZ and the length of the intervening segment between the two HPZs. The former represents the degree of the diaphragmatic impingement on the herniated stomach and the latter the size of the supradiaphragmatic herniated stomach. Surgical reduction of the hernia resulted in relief of dysphagia in 91% of the patients.
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PMID:The cause of dysphagia in uncomplicated sliding hiatal hernia and its relief by hiatal herniorrhaphy. A roentgenographic, manometric, and clinical study. 232 35


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