Paraesophageal Hernia

Abstract

The treatment of PEHs is challenging. They tend to occur in patients in their 60s and 70s with multiple medical problems and a variety of associated symptoms. Detailed preoperative evaluation is crucial to determining a safe and effective strategy for repair in the operating room. Laparoscopic PEH repair has shown to be advantageous compared with conventional open repair with regard to hospital stay, recovery time, and decreased complications. Although some results indicate there are higher recurrence rates in laparoscopic PEH repair, the clinical significance of these recurrences has not yet been determined. In order to maximize the efficacy of this procedure, modifications have emerged, such as performing a fundoplication and using an absorbable mesh onlay to reinforce the cruroplasty. Althoughmoreprospective, randomized studies are needed to support the superior results of these surgical adjuncts, laparoscopic PEH repair with an antireflux procedure and absorbable mesh should be the current standard of care.

Chest Pain: A Relatively Benign Symptom of Type IV Hiatal Hernia

“…Prokinetic agents do not have a major role in the management of hiatal hernias [ 4 ]. Surgical intervention is reserved for large hernias, PEHs with recurring symptoms, and in patients presenting with clinical features of incarceration or strangulation of the abdominal contents [ 14 ]. Additionally, the symptoms of advanced types (II-IV) of hernias warrant immediate evaluation and intervention due to the significant risk of complications [ 1 , 12 ].…”

Acute abdomen in a patient with paraesophageal hernia, resulting in acute compromised respiratory function: A case report

“…The cause of hiatal hernias is related to increased intra-abdominal pressure, causing a transdiaphragmatic pressure gradient at the gastroesophageal junction. This results in weakening of the phrenoesophageal membrane and widening of the esophageal hiatus [3] . Most patients with a paraesophageal hernia are believed to be asymptomatic.…”

“…Symptoms can be caused by obstruction, gastroesophageal reflux disease, bleeding, and iron deficiency anaemia. Other non-specific symptoms associated with paraesophageal hernias are postprandial fullness, chest pain, and breathing difficulties [2] , [3] . Patients with paraesophageal hernias can also present acutely with gastric volvulus and incarceration, which requires immediate surgical intervention [2] , [3] .…”

“…Other non-specific symptoms associated with paraesophageal hernias are postprandial fullness, chest pain, and breathing difficulties [2] , [3] . Patients with paraesophageal hernias can also present acutely with gastric volvulus and incarceration, which requires immediate surgical intervention [2] , [3] . Currently, asymptomatic or minimally symptomatic paraesophageal hernias are monitored using watchful waiting, and only symptomatic hernias are recommended for elective hernia repair [2] .…”

Laparoscopic Hiatal Herniorrhaphy in a Large Hiatal Hernia as a Rare Cause of Dyspnea and Anemia: A Case Report

“…Type I hernias may be associated with gastroesophageal reflux disease, and its related symptoms include heartburn, epigastric pain, and Barrett's epithelium (5). Additionally, mild and acute obstructive symptoms may be seen in type I hernia patients (6). Dysphagia, postprandial fullness, and upper abdominal pain occur in these patients, but the pain is often relieved by vomiting (2).…”