Congenital hiatus hernia-A case series

Abstract

OBJECTIVE: Hiatus hernia is frequent in adults and rare in children; congenital hiatus hernia is even rarer. In this study, we describe a group of infants with congenital hiatus hernia and discuss its management. METHODS: Records of patients (male: 3, female: 4) who were diagnosed with congenital hiatus hernia between 2010 and 2016 were extracted. Demographic data, presenting symptoms, diagnostic investigations, operative details, postoperative follow-up, and early and late postoperative complications were evaluated retrospectively. RESULTS: Four patients were female and three were male. One patient was diagnosed prenatally while the mean age at diagnosis for others was 18.6 months. Four patients had type IV hernia, 2 had type III hernia, and one had type I hernia. The diagnosis was confirmed by chest X-ray, computerized tomography (CT) and/or upper gastrointestinal series. The hiatal repair was done in all patients either by laparotomy or laparoscopy. During the procedure, 2 patients had Nissen fundoplication and 3 patients had Thal fundoplication. Recurrence of hernia occurred in the 2 patients who had Thal fundoplication. CONCLUSION: Recurrence of sliding hernias with Thal fundoplication seem more frequent in the series. If the esophagogastric junction is present in the thorax, mediastinal dissection of the esophagus may be required to achieve a good abdominal esophagus structure, which will prevent a recurrence.

A rare cause of a cavitary lung lesion in an infant

“…The literature additionally suggests adding fundoplication may help to prevent recurrence by fixing the gastroesophageal junction and stomach 4. Despite these interventions, recurrence rates have been reported between 7% and 11% 1,2…”

“…Paraesophageal hernias, also known as hiatal hernias, are a well-known entity in adults but are exceedingly rare in children 1,2. This type of hernia in children is most often acquired, but also can be congenital.…”

“…Paraesophageal hernias, also known as hiatal hernias, are a well-known entity in adults but are exceedingly rare in children. 1,2 This type of hernia in children is most often acquired, but also can be congenital. Acquired hiatal hernias most often result following anti-gastroesophageal refl ux surgery, such as fundoplication, or less commonly trauma.…”

“…Common presenting symptoms include vomiting, gastroesophageal reflux, frequent respiratory infections, failure to thrive, and anemia. [1][2][3][4] Given these nonspecific symptoms, congenital paraesophageal hernias can be diffi cult to diagnosis. Hernias typically are visible on chest radiograph, but can often be misdiagnosed.…”

Application of Laparoscopic Repair for Neonatal Esophageal Neonatal Hiatal Hernia

“…The Berrott classi cation of hiatal hernia is divided into four types [1]. At present, surgical indications and surgical timing for patients with esophageal hiatal hernia are still controversial [2,3]. For type I neonates, some scholars believe that conservative treatments should be performed rst, and timely surgical treatment should be performed if recurrent vomiting, esophagitis, bleeding, and no increasing of weight occur.…”