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

Paraesophageal herniation can cause massive bleeding, strangulation or perforation. This study reviews the experience with 24 patients (74.6 years, range 63-89 years, 20 males, 4 females) with a total or near-total intrathoracic stomach, managed at the Royal Lancaster Infirmary. All patients were symptomatic with 3/24 patients presenting as emergencies. Twenty-three of 24 patients underwent surgery: gastropexy alone-5, gastropexy and hiatal repair-17, gastropexy, hiatal repair and fundoplication 1. One of the emergency patients died prior to surgery. Median operative time was 50 min (range 35-65 min) and median hospital stay was 7 days (range 5 days-3 weeks). A splenectomy was necessary in 1/23 (4.4%) patients. Postoperative morbidity included: recurrent hernia requiring surgery-1, pleural effusion requiring chest tube-1, empyema-1, dysphagia requiring dilatation-1, reflux with stricturing-1. Elderly patients with a total or a near-total intrathoracic stomach can be managed by gastropexy and hiatal repair, with acceptable morbidity.
Dis Esophagus 1998 Jul
PMID:Management of patients with giant paraesophageal hernia. 984

Diaphragmatic hernias are the most common abnormalities of gastrointestinal system especially in elderly patients. The radiographic findings of diaphragmatic hernias on esophagram are well known, but when incidentally found in an asymptomatic patient on axial computed tomography (CT) sections, the appearance of diaphragmatic hernia may mimic many other conditions. Our purpose is to present the CT findings of sliding hernia in an incidentally found asymptomatic patient, and to differentiate it from the other abnormalities that can be located in the distal paraesophageal area with the same appearance characteristics.
Dis Esophagus 2002
PMID:Sliding hernia simulating esophageal tumor on computed tomography. 1222 Apr 31

The mixed-type esophageal hernia is an indication for operation to prevent stomach volvulus and perforation. However, preventive operation is meaningful depending on the physical status. We encountered an 84-year-old, demented, bed-ridden woman of mixed-type esophageal hernia complicated with severe reflux esophagitis. First, the patient was conservatively treated by intravenous hyperalimentation and H2 blocker but, with onset of delirium, she removed the venous route twice. Subsequently, she was tightly restrained to the bed to avoid removing the line. Ethical deliberation for the patient tightly fixed to the bed and intravenous alimentation for her life prompted us to reconsider hernia operation after discussion with surrogate decision makers. The patient recovered uneventfully after operation, and movement without intravenous route or without any restraints was maintained by oral feeding assisted by gastrostomy feeding. In the coming decade, when senior patients are expected to increase, such operations can be forwarded to respect the patients' quality of life.
Dis Esophagus 2002
PMID:Esophageal hernia in dementia: surgeon's role for mixed-type esophageal hernia in an elderly woman with dementia. 1244 1

In this article we analyze our experience of surgical treatment of hiatal hernia, complicated with gastroesophageal reflux. We operated 134 patients with hernia hiatus esophagi, complicated with gastroesophageal reflux, from 03.1998 till 10.2001. One hundred twenty-six Nissen and 8 Toupet laparoscopic gastrofundoplications were performed. We evaluated clinical signs of gastroesophageal reflux, performed endoscopy and esophageal biopsy with histological examination and stomach X-ray examination with barium meal before the operation. Esophagus and stomach X-ray examination with water contrast on the first day after operation were performed in order to evaluate the position and function of created wrap. We also analyzed intraoperative and postoperative complications. Long-term follow-up (12 months) was obtained by using a structured questionnaire. We evaluated heartburn, dysphagia, regurgitation and patient's satisfaction of surgery. RESULTS. Postoperative complications rate was 8.96%. Eighty-two percent of our patients completed our questionnaire. Ninety-one percent of patients had no heartburn signs, 95.5% any signs of regurgitation. Eighty-three percent of our patients were satisfied with our performed laparoscopic gastrofundoplication. We performed 6 refundoplications, when gastroesophageal reflux clinical signs renewed shortly after operation. CONCLUSIONS. Laparoscopic gastrofundoplication is a safe and effective treatment of hernia hiatus esophagi, complicated with gastroesophageal reflux. Operation success was about 90% in our study. Recurrences are more frequent in elderly patients or those with long disease anamnesis. Refundoplications can be successfully done laparoscopicaly as well.
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PMID:[Hiatal hernia and gastroesophageal reflux: possibilities and results of surgical treatment]. 1255 61

Paraesophageal hiatal hernia is an uncommon condition that requires urgent correction to prevent life-threatening complications. It is present in 14% of all hiatal hernias. The incidence of Morgagni hernia among all diaphragmatic defects is 3-4% and about 90% of the hernias occur on the right, 8% are bilateral and 2% are on the left. The combination of a Morgagni hernia and paraesophageal hernia is very rare and only four cases have been reported in the literature. All of them occurred in the right. This report describes an old case admitted to our clinic with dyspnea, chest pain and chronic gastrointestinal symptoms, found to have combined left Morgagni and paraesophageal hernia. Surgical repair was performed via transabdominal approach. This unusual case and surgical approaches are discussed in light of the data presented in the literature.
Dis Esophagus 2003
PMID:Combination of paraesophageal hernia and Morgagni hernia in an old patient. 1282 18

Diaphragmatic hernia is an uncommon complication that can follow transhiatal esophagectomy. It has not been reported after minimally invasive esophagectomy. We report such a case presenting with features of small bowel obstruction. The paucity of adhesions following the combined laparoscopic and thoracoscopic approach may confer an increased risk of this complication.
Dis Esophagus 2004
PMID:Diaphragmatic hernia after minimally invasive esophagectomy. 1523 Jul 37

The treatment of para-esophageal hernia by the laparoscopic approach has been described by a number of authors. The lower morbidity of the laparoscopic approach compared with the open approach holds some attraction, however, reservations regarding the durability of laparoscopic repair exist. There is a paucity of objective follow-up data in the literature with regard to repair durability and symptomatic outcome. A review was undertaken of 94 patients over a 7 year period undergoing attempted laparoscopic repairs of para-esophageal hernia. Preoperative and operative data was collected and patients underwent postoperative interview and barium meal. Laparoscopic repair was successfully completed in 86 patients. Symptomatic reherniation occurred in 12% (10/86) of patients undergoing laparoscopic repair. These patients underwent open reoperative surgery. There were no symptomatic recurrences in patients undergoing initial open repair. Symptomatic outcome was assessed by interview in 78% (73/94) of patients at a median of 27 months (3-93 months) postoperatively. Ninety-seven percent (71/73) of patients were satisfied with their ultimate symptomatic outcome however, this group included seven patients who had required reoperative surgery for symptomatic recurrence and were therefore laparoscopic failures. In order to determine the asymptomatic recurrence rate patients were requested to undergo a barium meal. A further nine small asymptomatic recurrences were diagnosed in 42 patients having had laparoscopic repair. This represents an asymptomatic radiographic recurrence rate of 21%. Laparoscopic repair in this series was associated with a 12% symptomatic recurrence rate. The majority of patients with symptomatic recurrence underwent open reoperation with good results. Strategies for reducing recurrences should be examined in prospective series.
Dis Esophagus 2004
PMID:Symptomatic and radiological follow-up after para-esophageal hernia repair. 1556 63

We report on a 75-year-old woman with an isolated colonic hernia through the esophageal hernia. The patient had suffered from cough, palpitation and dyspnea. A chest X-ray showed a colon loop gas in the mediastinum. Simultaneous barium swallow and enema showed the herniation of the only transverse colon into the mediastinum and displacement of the distal esophagus by the migrated colon. The patient underwent an open-mesh cruroplasty and a Hill's posterior gastropexy. The postoperative clinical course was uneventful. The patient has cessation of the symptoms. To our knowledge, there are only five reports presenting patients with isolated colonic hernia through the esophageal hiatus, including our case.
Dis Esophagus 2005
PMID:Isolated colonic hernia through the esophageal hiatus. 1612 88

Patients with iron deficiency anemia sometimes have a large paraesophageal hernia and no other explanation for their chronic blood loss. The management of these patients can be a dilemma, especially when the hernia is otherwise asymptomatic. We aimed to determine whether a laparoscopic repair of the hernia could cure the anemia. We reviewed a consecutive series of 11 cases of iron deficiency anemia associated with a large paraesophageal hernia, many without associated linear gastric erosions, managed by laparoscopic repair and fundoplication. There was one conversion in a patient with dense adhesions from previous upper abdominal surgery. Another patient required a laparoscopic reoperation for an early recurrence. Major morbidity occurred in three patients and there was no mortality. There was no recurrence of anemia after a median follow-up of more than 2 years. Iron deficiency anemia in association with a large paraesophageal hernia can be treated by laparoscopic repair with acceptable morbidity and minimal mortality. The complications of a large paraesophageal hernia are also prevented.
Dis Esophagus 2005
PMID:Effect on iron deficiency anemia of laparoscopic repair of large paraesophageal hernias. 1619 33

Minimally invasive techniques are increasingly being used for oesophagectomy. Diaphragmatic hernia is a rare complication of gastroplasty in open surgery. One of the advantages of the laparoscopic technique, the lack of peritoneal adhesions, may lead to an increased rate of this complication. We report two cases of diaphragmatic acute massive herniation after laparoscopic gastroplasty for esophagectomy out of a series of 44 laparoscopic gastroplasties performed over 33 months. We discuss some technical aspects related to its occurrence. Prevention should include a limited crural division and fixation of the gastric tube to the diaphragmatic crura at primary surgery.
Dis Esophagus 2006
PMID:Diaphragmatic acute massive herniation after laparoscopic gastroplasty for esophagectomy. 1636 43


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