Cases reported "Hernia, Hiatal"

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1/61. Right-sided hiatal hernia of the oesophagus.

    At chest radiography performed for recurrent pneumonia in a 3-month-old boy, an air-fluid level in the right cardiophrenic angle was found and initially perceived as a lung abscess. upper gastrointestinal tract radiographs, however, revealed a congenital diaphragmatic hernia, which was successfully repaired.
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2/61. Transient left vocal cord paralysis during laparoscopic surgery for an oesophageal hiatus hernia.

    A 45-year-old male, with symptoms of many years standing of gastro-oesophageal reflux disease, was subjected, under general anaesthesia, to laparoscopic fundoplication. Tracheal intubation yielded no problems but great difficulties were encountered during tube insertion into the oesophagus. After surgery, aphonia developed. Laryngological examination demonstrated paralysis of the left vocal cord. voice strength returned to the pre-operative status after 3 months, and laryngological examination confirmed normal mobility of both cords. The possible cause of the complication was damage to the left recurrent laryngeal nerve which occurred during insertion of the tube into the oesophagus. Gastro-oesophageal reflux disease causing 'acid laryngitis' can create conditions favouring this type of complication.
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3/61. Esophago-gastric invagination in patients with sliding hiatus hernia.

    intussusception of the distal esophagus into a reducible hiatus hernia is described in nine female and three male patients. The main radiographic feature is demonstration of a lobulated fundal mass of changeable size and configuration surrounding the narrowed distal esophageal segment. This pseudotumor is produced by inversion of the hiatus hernia into the stomach, and may be mistaken for a neoplasm. Disinvagination invariably occurs when maneuvers directed toward demonstration of a sliding hernia are utilized during upper gastrointestinal fluoroscopy. It is emphasized that esophago-gastric invagination frequently accounts for masses shown in the cardia of older women with intermittent dysphagia and crampy epigastric pain.
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4/61. Oesophageal surgery.

    A wide variety of benign conditions affecting the oesophagus which have long been recognized in association with hiatus hernia are now known to be attributable to reflux oesophagitis. The development of modern methods of treatment of these conditions is described with reference to a number of illustrative cases.
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5/61. Serial sonographic findings in a fetus with congenital hiatal hernia.

    A continuum of prenatal findings in a case of hiatal hernia is described. Second-trimester scans showed absence of fetal stomach and polyhydramnios suggestive of esophageal atresia. Third-trimester scans revealed a dilated tubular structure in the thoracic cavity with intermittent visualization of an intra-abdominal small stomach. A diagnosis of hiatal hernia was entertained. After birth, the diagnosis of a dilated esophagus with the stomach herniated into the thoracic cavity through a very lax esophageal hiatus was confirmed and the baby underwent corrective surgery.
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6/61. adenocarcinoma in a Barrett oesophagus.

    A case of adenocarcinoma developing at the squamocolumnar epithelial junction of a Barrett oesophagus is reported. This rare tumour was remarkable because of the youth of the patient and because of the signet-cell cytological pattern of the neoplasm. It is postulated that both the columnar epithelial lining of the lower part of the oesophagus and the malignant change are a consequence of long-standing oesophageal reflux.
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7/61. Coexisting achalasia and paraoesophageal hiatal hernia.

    Disorders of the oesophagus present a diagnostic and therapeutic challenge. The presenting symptoms of dysphagia, reflux, pain and vomiting are almost universal, irrespective of the underlying pathology. A combination of endoscopy, barium studies, pH studies and manometry are often required to determine the exact diagnosis and to plan the most effective treatment. Paraoesophageal hiatal hernia is an uncommon condition, present in 14% of all hiatal hernias, which requires urgent correction to prevent life-threatening complications. It is unusual for other oesophageal disorders to coexist. We present a case where achalasia and a paraoesophageal hiatal hernia probably coexisted.
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8/61. Crohn's disease of the esophagus.

    Two cases of Crohn's disease involving the esophagus are described. Both patients had Crohn's disease elsewhere. Multiple intramural fistulous tracts are seen in both patients, and this is a characteristic feature of Crohn's disease. One patient developed a spontaneous esophago-bronchial fistula. Even though the esophageal involvement of Crohn's disease is rare, it should be suspected when a chronic esophageal inflammatory lesion develops in a patient who has Crohn's disease elsewhere, especially without hiatus hernia or other chronic disease.
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9/61. Outpatient laparoscopic Nissen fundoplication.

    gastroesophageal reflux disease affects more than 40% of Americans, causing heartburn and reflux of gastric contents into the esophagus when bending or lying down. Lifestyle modification, such as weight loss and a diet rich in protein and low in fat and glucose, should increase the patient's resting lower esophageal sphincter pressure. Avoiding exacerbating substances, such as mint, chocolate, alcohol, and tobacco, also may reduce symptoms. Medications may be prescribed to reduce persistent symptoms, although no medication currently available cures the disease process. patients who need antireflux medication regularly for four to six weeks or more may be candidates for laparoscopic Nissen fundoplication. patients who do not want to take antireflux medication for the rest of their lives, cannot afford the medication for an extended period of time, or suffer significant side effects from the medication also are candidates. This article describes performing Nissen fundoplication laparoscopically on an outpatient basis. The average length of hospital stay has been decreased to two to three hours when performed laparoscopically on an outpatient basis from 10 days for the open procedure and two to three days when performed laparoscopically on an inpatient basis. The incidence of recurrent heartburn is less than 2% when the procedure is performed laparoscopically and does not appear to be clinically significant.
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10/61. An evaluation of the Nissen fundoplication.

    The characteristic radiological findings which follow a Nissen fundoplication are reviewed. The esophagus may be narrowed but is intrinsically normal. A pseudotumor at the medial aspect of the fundus is generally present. The history and radiographic findings can normally differentiate this defect from neoplasm or a nonoperated hiatal hernia. Postoperative clinical evaluation has shown this procedure to be very valuable in the amelioration of symptoms.
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