|Discussion in 'All Categories' started by Robert Morgan - Feb 18th, 2013 11:52 pm.|
|The entire stomach is noted in the thoracic cavity in thepoeterior mediastinum and displacing the heart anteriorly. The jiatus opening is about 4cm in diamater.
There is alos suggestion of organo-axial volvulus of the stomach
re: Hiatus Hermia by Dr J S Chowhan - Feb 22nd, 2013 11:24 am
Dr J S Chowhan
Paraesophageal hernias represent advanced degrees of sliding hiatus hernia with intrathoracic displacement in the intraesophageal junction. Gastroesophageal reflux disease occurs in many instances, resulting in acquired short esophagus, which will influence the type of repair selected.
Sign of incarceration with the herniated stomach, that has been frequently complicated by organoaxial volvulus. Common presentations of large incarcerated hernias are postprandial fullness or pain, dysphagia, iron-deficiency anemia related to chronic hemorrhage in the incarcerated gastric pouch, and regurgitation with aspiration.
Essentially the most compelling evidence for the proper diagnosis of sliding paraesophageal hernia will be the endoscopic location with the esophagogastric junction at the level across the diaphragmatic hiatus. Using the flexible gastroscope, it is possible for your experienced operator to simply locate how much the esophagogastric junction and the degree of the diaphragmatic hiatus.
Most paraesophageal hernias represent advanced degrees of sliding hiatus hernia with intrathoracic displacement of the esophagogastric junction. GERD happens in 83% of those cases and frequently leads to acquired short esophagus. Ahead of the operation, the evaluation of acquired short esophagus is better determined from measurements of esophageal length during endoscopy and manometry. The position of the esophagogastric junction is difficult to get inside a traditional contrast esophagogram.
The existence of acquired short esophagus should influence the repair selected. Acquired short esophagus could be confirmed at operation and is also most easily evaluated throughout the operation through a transthoracic approach.
So in our opinion you should contact us or any good hospital where surgery can be performed and your hernia can be repaired.
J S Chowhan
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