Re: Esophogeal hernia and surgery

Posted By HFHSM.D.-ym on August 20, 1998 at 20:26:13:

In Reply to: Esophogeal hernia and surgery posted by HFHSM.D.-ym on August 19, 1998 at 18:53:20:







: : Hi once again! This is just to add some new information to my posted message
of 8/13/98 (no response yet). My father did have the endoscopy and nothing
abnormal (beyond the hernia) was seen. I'm unclear on if he has a sliding
or an esophogeal hernia, but the doctors told him it was elective surgery.
If he decided to do it, they would put 2 stitches in the esophogas. It's
very hard to picture--do you know if there are any good diagrams of these
types of hernias on the internet? Thanks for any information you can provide!
Dear Donna,
I don't know of any pictures on the internet, but you could ask your surgeon for a brochure outlining surgery for hiatal hernia and gastroesophageal reflux. We have one in our office, I'm almost sure he or she has one too. Another option is to try one of the internet search engines. Good luck to your father.
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 would like 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:  gastroesophageal reflux, hiatal hernia, surgery

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