The Impact of Scoliosis Among Patients with Giant Paraesophageal Hernia

Schuchert, Matthew J.; Adusumilli, Prasad S.; Cook, Chris C.; Colovos, Christos; Kilic, Arman; Nason, Katie S.; Landreneau, Joshua P.; Zikos, Thomas; Jack, Robert; Luketich, James D.; Landreneau, Rodney J.

doi:10.1007/s11605-010-1307-7

Cited by 27 publications

(18 citation statements)

References 35 publications

(22 reference statements)

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“…Scoliosis and kyphosis can distort the anatomy of the diaphragm; scoliosis is present in almost a third of patients with giant paraesophageal hernia. 10 Congenital defects are the most common cause of paraesophageal hernia in children, sometimes associated with other malformations, such as intestinal malrotation. 11…”

Section: What Are the Risk Factors?mentioning

confidence: 99%

The diagnosis and management of hiatus hernia

Roman

Kahrilas

2014

BMJ

144

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Section: What Are the Risk Factors?mentioning

confidence: 99%

The diagnosis and management of hiatus hernia

Roman

Kahrilas

2014

BMJ

144

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“…The giant diaphragmatic hernia associated with intrathoracic stomach is a very rare entity (1) that seems to be related to increased intra-abdominal pressure and diaphragmatic laxity or kyphoscoliosis deviation in obese patients (2). Usually it corresponds to a type III hiatal hernia, with both sliding and paraesophageal components, wherein at least 30% of the stomach is in intrathoracic situation (3).…”

Section: Discussionmentioning

confidence: 99%

Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT

García-Gómez

Riva-Pérez

Calvo-Morón

et al. 2017

Arch. Endocrinol. Metab.

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SUMMARYThe whole-body iodine-131 scintigraphy is an imaging technique in monitoring patients with a history of thyroid cancer. Although the rate of false positives is negligible, it is not nonexistent. We report the case of an intervened and treated patient for thyroid cancer with good clinical and biochemical response. Scintigraphic findings were consistent with unsuspected bone metastasis. Fused SPECT/CT data allowed accurate diagnosis of giant diaphragmatic hernia associated with intrathoracic stomach, a very rare pathology that can lead to false positive results. Arch Endocrinol Metab. 2017;61(3):288-90. Subsequently, a single photon emission computed tomography/computed tomography (SPECT/CT) was performed due to discordance between biochemical findings (low hormone levels) and the clinical picture of intense back pain and functional imaging consistent with spine bone metastasis. A severe thoracolumbar scoliosis that determines a giant diaphragmatic hernia was revealed thanks to multimodality scan (Figure 2). Thereby, high intense hypermetabolic foci corresponded to physiological activity of the improperly positioned gastric mucosa mimicking bone metastasis.

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“…Postoperatively, the patient's postural balance improved, which also helped to reduce her gastroesophageal reflux symptoms. Correction of spinal deformity could result in better treatment outcomes in patients with combined hiatus hernia and reflux gastroesophagitis [7,9,10]. Previous reports recommended surgical treatment to address the combination of reflux gastroesophagitis and hiatus hernia for patients who were unresponsive to pharmacotherapy [5,7].…”

Section: Discussionmentioning

confidence: 99%

“…The association between neuromuscular scoliosis and hiatus hernia is documented [2,10]. Axial deviation of the vertebral column at the level of the hiatus results in decreased intraabdominal volume and stretching of the esophageal sphincter [6].…”

Section: Introductionmentioning

confidence: 99%

Improvement in Reflux Gastroesophagitis in a Patient with Spinal Muscular Atrophy after Surgical Correction of Kyphoscoliosis: A Case Report

Yang

Kasat

Suh

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Scoliosis, a three-dimensional deformity, has secondary effects on the gastrointestinal system. Reflux gastroesophagitis with hiatus hernia in patients with scoliosis is difficult to manage. We present a patient in whom primary correction of a spinal deformity was associated with resolution of symptoms of reflux. Case Description A 15-year-old girl with severe thoracolumbar kyphoscoliosis visited our scoliosis research institute complaining of back pain, positional imbalance, intermittent respiratory tract infections, and gastrointestinal discomfort such as pain, dysphagia, and heartburn for several years. On preoperative CT, her abdominal organs were in a deviant position, and esophagogastroduodenoscopy revealed severe reflux gastroesophagitis, Los Angeles classification (LA) Grade D, and a sliding hiatus hernia. After kyphoscoliosis correction, the patient's truncal balance and pain improved. Postoperatively, the patient reported abdominal pain and dysphagia that gradually subsided after 3 weeks. At 1 year, the patient had no abdominal complaints secondary to reflux gastroesophagitis, and episodes of recurrent respiratory tract infections were substantially reduced. Postoperative evaluation showed the reflux gastroesophagitis had improved to LA Grade A. Postoperative CT showed the abdominal cavity had expanded and the abdominal organs were more centered. Literature Review The association between scoliosis and reflux gastroesophagitis is well documented. However, the secondary effects of scoliosis correction on gastrointestinal symptoms caused by reflux gastroesophagitis have not been investigated in detail. Purpose and Clinical Relevance This patient illustrates the relationship between spinal deformity and gastrointestinal symptoms. Postural balance correction resulted in the alleviation of reflux gastroesophagitis symptoms secondary to hiatus hernia.

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The Impact of Scoliosis Among Patients with Giant Paraesophageal Hernia

Abstract: Kyphoscoliosis may contribute to the development and progression of paraesophageal hernias. Surgeons approaching paraesophageal hernia repair should be aware of the increased pulmonary morbidity and the postoperative care required in managing these patients.

Cited by 27 publications

References 35 publications

The diagnosis and management of hiatus hernia

The diagnosis and management of hiatus hernia

Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT

Improvement in Reflux Gastroesophagitis in a Patient with Spinal Muscular Atrophy after Surgical Correction of Kyphoscoliosis: A Case Report

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