Incarcerated paraesophageal hernia

Hill, Lucius D.

doi:10.1016/s0002-9610(73)80165-5

Cited by 237 publications

(107 citation statements)

References 3 publications

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“…Hastalarımızın tanısında akciğer grafisi ve BT yeterli olduğu için ultrason ve MR'a gerek duyulmamıştır. Plikasyon diyafragma çevresinde göğüs kafesi boyunca sıra halinde teflon plejitli ya da plejitsiz dikişler yerleştirilerek yapılır [6]. Biz hastalarımızda prolen no:0 teflon plejitsiz sütürler kullandık.…”

Section: Discussionunclassified

Clinical Experience with Diaphragmatic Eventrations

Akar¹

2012

Ann Clin Anal Med

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ÖzetAmaç: Yetişkinlerde görülen diyafragma evantrasyonu ve paralizisi, sebebi tam olarak açıklanamayan ve nadir görülen hastalıklardandır. Kliniğimizde 2007-2011 yılları arası diyafragma evantrasyonu ve disfonksiyonları nedeniyle operasyona alınmış 10 hastayı klinik özellikleri ve cerrahi seçenekler yönünden inceledik. Gereç ve Yöntem: Göğüs X-ray filimleri, bilgisayarlı gö-ğüs tomografisi ve floroskopi, hastaların ameliyat öncesi değerlendirilmele-rinde kullanıldı. Bütün hastalara sadece preoperatif dönemde solunum fonksiyon testi yapıldı. Hastalara sol posterolateral torakotomi insizyonu ile yaklaşıldı. Bir hastada politetrafloroetilen greft, üç hastada santral tendon plikasyonu ve altı hastada ise diyafragma yaprakları üst üste kaydırılarak operasyon yapıldı. Bulgular: Hastaların beşi erkek beşi kadındı. Yaş aralığı 13-68 yıl olup ortalama yaş 39,5 yıl idi. Hastalarda travma ve geçirilmiş enfeksiyon bulguları ile kronik hastalık öyküsü yoktu. Hastaların postoperatif çekilen akciğer filimlerinde diyafragmanın en az iki kot aşağıya indirildiği görüldü. Hastaların hastanede kalma süreleri ortalama 8,5 gündü (5-15 gün). Uygulanan cerrahi yöntem farklılıklarına rağmen hastalar arasında hastanede kalış süre-si, semptomların gerileme sürelerinde belirgin farklılık görülmediği gibi nüks-te görülmedi. Sonuç: Her üç cerrahi yöntem farklılığından sonra prognozun iyi seyretmesi, kalıcı problemlerin görülmemesi ve egzersiz kapasitelerinde anlamlı klinik artışın olması diyafragma evantrasyonu ve disfonksiyonlarında operasyon önermemize neden olmuştur. Anahtar KelimelerDiyafragma Yükselmesi; Paralizi; Torakotomi Abstract Aim: Diaphragmatic eventrations and paralysis in adulthood are among the rare conditions with unknown etiology. We evaluated 10 patients who were operated on because of diaphragmatic eventrations and dysfunctions between 2007 and 2010 in terms of clinical features and surgical options. Material and Method: Chest X-ray films, chest computed tomography and fluoroscopy, preoprerative evaluation of patients was used. Respiratory function tests were done for all patients only in preoperative period. Patients were approached with left posterolateral thoracotomy incision. One patient underwent polytetrafluoroethylene grafting, three patients underwent central tendon plication and six patients were operated by overlapping diaphragmatic parts. Results: Five patients were male and five patients were female with mean age of 39,5 years (range 13-68). Patients did not have a history of chronic diseases and findings of trauma or previous infections. Diaphragm was seen to get down at least two ribs on chest x-rays obtained postoperatively. Mean duration of hospital stay was 8,5 days (5-15 days). There was not a significant difference between patients in terms of duration of hospital stay, time to regression of symptoms despite different surgical methods. Discussion: Good prognosis, absence of permanent problems and significant clinical improvement of exercise capacity led us to recommend surgery for diaphragmatic eventrat...

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Section: Discussionunclassified

Clinical Experience with Diaphragmatic Eventrations

Akar¹

2012

Ann Clin Anal Med

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“…Initial management should include intravenous fluid resuscitation, correction of electrolyte abnormalities, and immediate gastric decompression, which can be achieved with the placement of a nasogastric tube. 2,10 Importantly, even if the patient does not appear systemically ill, has significant abdominal pain, and is not tender on examination, a prompt evaluation and reduction of volvulus are necessary to prevent progression to gastric ischemia ( Figure 10). …”

Section: Overview and Initial Managementmentioning

confidence: 99%

“…Although elongation of these structures may occur with the stomach in its normal subdiaphragmatic position, it is more commonly found that elongation of these structures -and subsequent gastric volvulus -occurs with a paraesophageal (PEH) or diaphragmatic (traumatic, Morgagni, Bochdalek) hernia. [1][2][3][4] Some patients present with an incidental finding of gastric volvulus on a radiographic study obtained for another purpose. In these patients, the gastric volvulus is frequently incomplete (<180 degrees) and therefore may not result in symptoms that the patient voluntarily reports.…”

Section: Introductionmentioning

confidence: 99%

Managing obstructive gastric volvulus: challenges and solutions

Rodriguez-Garcia¹,

Wright²,

Yates³

2017

OAS

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Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastric obstructive symptoms. However, severe acute gastric volvulus can result in complete gastric outlet obstruction and ischemia. Consequently, acute gastric volvulus warrants immediate evaluation and management. The goals of management are to relieve the obstruction and prevent recurrent volvulus. Techniques to manage gastric volvulus depend on patient characteristics and the presence of gastric ischemia. In the absence of gastric ischemia, gastric volvulus can be managed with anterior abdominal wall gastropexy or paraesophageal hernia repair. If gastric ischemia is present, operative resection of the affected portion of the stomach is indicated. When operative management is indicated, many patients with gastric volvulus can be managed with minimally invasive (laparoscopic, endoscopic, or laparoendoscopic) techniques.

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“…9 In the subset of patients who develop gastric volvulus, the death rate can be as high as 100%. [10][11] Given the significant complications that can occur, giant PEH should be electively repaired. When repair is performed electively, the death rate is less than 1% to 2% in most series.…”

Section: Introductionmentioning

confidence: 99%

“…When repair is performed electively, the death rate is less than 1% to 2% in most series. [10][11][12][13] Traditionally, repair of giant PEH has been performed through an open laparotomy or thoracotomy. This population of patients is often elderly, with comorbidities, which has led to concern over surgical referral.…”

Section: Introductionmentioning

confidence: 99%

Study of laparoscopic repair of hiatus hernia

et al. 2017

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Background: Traditionally, repair of giant PEH has been performed through an open laparotomy or thoracotomy. This population of patients is often elderly, with comorbidities, which has led to concern over surgical referral. With the advent of laparoscopy, giant PEHs are now being approached with minimally invasive techniques. Less invasive procedures may decrease the amount of postoperative pain and the perioperative complication rate and shorten recovery time. Recently, a few series have reported that laparoscopic repair of PEH is technically feasible, effective, and safe. Thus, once paraoesophageal hernia is identified current thinking is that it should be surgically treated regardless of symptoms. Methods: Prospective study of patients diagnosed with hiatus hernia on endoscopy and barium swallow was conducted from October 2010 to November 2013. All patients with consent were operated with standard laparoscopic Nissens fundoplication and some require crural repair and studied during the course.Results: 22 cases with haitus hernia type I 8 (36.41%), type II 7 (31.8%) and type III 7 (31.8%), 68.18% having heart burn, 54.55% regurgitation, dysphagia 36.36% and chest pain 31.82% were treated and observed preoperative, intraoperative and postoperative. Most cases 15 (68.18%) were between 61-70 years age group with 13 (59.09%) males and 9 (40.91%) females. 9.9% had asthma, 13.64% DM and 36.36% systemic HT out of 22 cases. Mean blood loss was 29.09 ml, mean operative time was 181.27±8.80 minutes, mean hospital stay was 3.68 days with 4.55% intraoperative complication, 4.55% postop complication rate having mean VAS on post op day 1 was 6.31 and on day 7 it was 0.52.

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Incarcerated paraesophageal hernia

Cited by 237 publications

References 3 publications

Clinical Experience with Diaphragmatic Eventrations

Clinical Experience with Diaphragmatic Eventrations

Managing obstructive gastric volvulus: challenges and solutions

Study of laparoscopic repair of hiatus hernia

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