[The para-esophageal hernia: a rare hiatal hernia requiring a specific approach]. / De para-oesofageale hernia: een zeldzame hiatushernia die een eigen aanpak vereist.
Ned Tijdschr Geneeskd
; 148(24): 1173-7, 2004 Jun 12.
Article
em Nl
| MEDLINE
| ID: mdl-15224426
ABSTRACT
In three patients, a woman aged 87 years who presented with signs indicating a myocardial infarction, a man aged 31 suffering from postprandial epigastric pain that suddenly worsened, and a woman aged 60 years with longstanding postprandial pain and recent fatigue due to anaemia, a para-oesophageal hernia was diagnosed. Para-oesophageal herniation is an uncommon disorder accounting for approximately 5% of all hernias at the oesophageal hiatus. They are distinguished from the more common sliding hiatal hernia by a relative preservation of the intra-abdominal fixation of the gastro-oesophageal junction. These patients show that the clinical presentation of para-oesophageal rolling hernias is different from that of sliding hernias. Pathological reflux may occur; though symptoms associated with a relative obstruction of the stomach within the hernia sac, such as dysphagia, are more common. Rare non-specific symptoms such as anaemia and loss of weight are also seen. Adequate therapy differs from that of a sliding hernia and should be individualized surgical correction is indicated in a healthy patient with a symptomatic para-oesophageal hernia, such as in the last patient. However, when the hernia is incidentally diagnosed or when comorbidity is present, such as in the first patient, a wait-and-see policy is recommended. Only in case of a threatening incarceration, such as in the second patient, is an emergency operation indicated.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hérnia Hiatal
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Nl
Revista:
Ned Tijdschr Geneeskd
Ano de publicação:
2004
Tipo de documento:
Article