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Surgical management of congenital hiatal hernia: A retrospective cohort study, single-center experience
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| Author:
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LAITH FATHI F. SHARBA, SAMER MAKKI MOHAMED AL-HAKKAK, FIRAS SHAKER MAHMOUD AL-FAHAM, JALAL JAAFAR ABDUL HUSSEIN
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| Abstract:
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Congenital Hiatal Hernia is herniation of a viscus or a part of it through the esophageal hiatus to an intrathoracic position. Evaluate our surgical management of Congenital Hiatal Hernia. A retrospective cohort study held in Al-Sader Teaching Hospital in Najaf/Iraq between 2003 and 2019. A detailed history took, and a thorough physical examination performed. The investigations included mainly chest radiographs, contrast swallow studies, and rigid esophagoscopy.Surgical techniques used laparotomy and left thoracotomy or both. Twenty-six cases of Congenital Hiatal Hernia were operated in a ratio of M: F (1.6:1), age range (25 days – 6 years). The chief presenting feature was frequent vomiting (in 20 patients), followed by recurrent chest infections. All patients sent to plain chest radiographs. The diagnosis depended primarily twenty-five of cases on contrast swallow studies. Two accesses utilized to repair Congenital Hiatal Hernia, Laparotomy for Nissen fundoplication and left thoracotomy for Belsy Mark IV procedure. Nineteen patients showed immediate postoperative relief. In 6 cases, need further surgery, one mortality included in this study caused by mediastinitis and septicemia. Early recognition of Congenital Hiatal Hernia is essential in reducing future complications. Thus, it is better to work as a team in diagnosis, management, and follow up. Nissen fundoplication did to infant age group with an excellent outcome. Hospitalization was slightly longer in patients who underwent Belsy Mark IV procedure compared with those operated utilized Nissen fundoplication, noting that the results were nearly the same.
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| Keyword:
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Congenital Hiatal Hernia; gastro-oesophagal reflux; lower oesophagal sphincter; Nissen fundoplication; Belsey Mark 4 procedure
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.04.511
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| Download:
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