Esophogeal hernia and surgery

    
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Posted by HFHSM.D.-ym on August 20, 1998 at 20:26:58:

In Reply to: Re: Re: Re: Esophogeal hernia and surgery posted by Donna on August 20, 1998 at 14:13:37:

: Thanks. I will do a seach once again on the internet for pictures.
  I would still like your feedback on the questions I posed in the
  first message on the 13th, if you get a chance. Thank you!

Dear  Donna,
There are two types of hernias that occur in the region of the lower esophagus i.e., a sliding hiatal hernia and a paraesophageal hernia. Sliding hiatal hernias are more common and are probably the type that you are referring to. A sliding hiatal hernia is a congenital abnormality where the lower esophagus and part of the stomach protrudes upward into the chest cavity. This is due to a weakness in the muscles and ligaments that support the stomach in its proper position. Hiatal hernias are commonly seen on chest x-rays and upper GI series. They can play a role in the development of gastroesophageal reflux or they can be totally
asymptomatic. A sliding hiatal hernia is usually an anatomic abnormality that causes no problems, doesn't get bigger or smaller with time and does not require surgical repair. In patients with hiatal hernia and gastroesophageal reflux symptoms, the usual treatment for gastroesophageal reflux suffices. If however your father is refractory to medical therapy a surgery to tighten the area around the lower esophagus can be  considered. The surgeon usually takes part of the stomach and wraps it around the lower esophagus. This is called a Nissen fundoplication. Today it is possible to perform this surgery with a laparoscope (thus allowing for a small scar and "two stitches"). It is important to find a surgeon who has expertise in laparoscopic surgery and who has done a number of these operations. You should also be comfortable with the risks, benefits and alternatives of the operation prior to consenting to it. On the other hand, a paraesophageal hernia is a protrusion of the stomach into the chest cavity where part of the stomach lies along the lower esophagus and can actually cause a mechanical obstruction (blockage). These are less common than sliding hiatal hernias and usually require surgical repair. I hope you find this information
helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you want to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: hiatal hernia, gastroesophageal reflux disease, management