The authors present the case of a patient with a large paraesophageal hiatal hernia complicated with organo-axial gastric volvulus. We discuss problems of diagnosis and therapeutical options.
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Cureus
December 2024
Internal Medicine, Salmaniya Medical Complex, Manama, BHR.
Hiatal hernias occur when abdominal contents protrude into the posterior mediastinum through the esophageal hiatus of the diaphragm. They are classified into four types, with Type I (sliding) being the most prevalent. We report a case of a patient diagnosed with a large Type IV paraesophageal hernia.
View Article and Find Full Text PDFJAMA Surg
January 2025
Section of Minimally Invasive Surgery, Department of Surgery, The University of Chicago, Chicago, Illinois.
Cureus
November 2024
Surgical Oncology, University Hospitals of Derby and Burton NHS Trust, Derby, GBR.
The utilization of transthoracic approaches for the repair of large hiatus hernias remains a topic of clinical debate. This study aims to evaluate the efficacy, safety, and recovery metrics for transthoracic hiatal hernia repair. A literature search was conducted using the key terms "hiatus hernia," "thoracotomy," "thoracic approach," and "Belsey Mark IV.
View Article and Find Full Text PDFUpdates Surg
November 2024
Division of General and Foregut Surgery, Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.
The optimal treatment for paraesophageal hiatus hernia (PEH) is controversial. While crural buttressing with mesh shows promises in reducing recurrences, the decision to use mesh during minimally invasive PEH repair is largely subjective. Due to these uncertainties, we conducted a survey to examine current clinical practices among surgeons and to assess which are the most important determinants in the decision-making process for mesh placement.
View Article and Find Full Text PDFSurg Endosc
November 2024
Division of Endocrine & Minimally Invasive Surgery, Department of Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
Background: Hiatal and paraesophageal hernia (HH/PEH) recurrence is the most common cause of failure after gastroesophageal anti-reflux surgery. Crural reinforcement with mesh has been suggested to address this issue, but its efficacy remains debated. In this study, we aimed to determine the impact of biosynthetic mesh reinforcement compared to suture cruroplasty on anatomic and symptomatic hernia recurrence.
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