Surgical Management of Hiatal Hernia in Children with Asplenia Syndrome

2016 ◽  
Vol 27 (03) ◽  
pp. 274-279
Author(s):  
Koji Fukumoto ◽  
Masaya Yamoto ◽  
Hiroshi Nouso ◽  
Masakatsu Kaneshiro ◽  
Mariko Koyama ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Duodenal Obstruction ◽  
Abdominal Cavity ◽  
The Other ◽  
Esophageal Hiatus ◽  
Thoracic Cavity ◽  
Toupet Fundoplication ◽  
Cavity Volume ◽  
Upper Gastrointestinal ◽  
Asplenia Syndrome

Purpose Patients with asplenia syndrome (AS) are likely to have upper gastrointestinal tract malformations such as hiatal hernia. This report discusses the treatment of such conditions. Methods Seventy-five patients with AS underwent initial palliation in our institution between 1997 and 2013. Of these, 10 patients had hiatal hernia. Of the patients with hiatal hernia, 6 had brachyesophagus and 7 had microgastria. Results Of the 10 patients with hiatal hernia, 9 underwent surgery in infancy (7 before Glenn operation, 2 after Glenn operation). Two underwent typical Toupet fundoplication, and the other 7 underwent atypical repair including reduction of the stomach. Two patients with atypical repair showed recurrence of hernia and required reoperation. Three patients required reoperation due to duodenal obstruction. Duodenal obstruction occurred due to preduodenal portal vein or abnormal vessels compressing the duodenum. Obstructive symptoms were not seen in any cases preoperatively. Conclusions In patients with hiatal hernia, typical fundoplication is often difficult because most have concomitant brachyesophagus, microgastria, and hypoplasia of the esophageal hiatus. However, we should at least reduce the stomach to the abdominal cavity as early as possible to increase thoracic cavity volume and allow good feeding. Increasing the volume of the thoracic cavity thus makes Glenn and Fontan circulations more stable. Duodenal obstruction secondary to vascular anomalies is also common, so the anatomy in the area near the duodenum should be evaluated pre- and intraoperatively.

scholarly journals Hiatal Hernia as a Total Gastrectomy Complication

2016 ◽  
Vol 9 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Bruna do Nascimento Santos ◽  
Marcos Belotto de Oliveira ◽  
Renata D'Alpino Peixoto
Keyword(s):  
Hiatal Hernia ◽  
Gastric Adenocarcinoma ◽  
Epigastric Pain ◽  
Abdominal Cavity ◽  
Esophageal Hiatus ◽  
The Third ◽  
Esophageal Anastomosis ◽  
Folfox Chemotherapy ◽  
Laparoscopic Assisted ◽  
Severe Epigastric Pain

Introduction: According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy. Case Report: A 76-year-old man was diagnosed with intestinal-type gastric adenocarcinoma. He underwent a total laparoscopic-assisted gastrectomy and D2 lymphadenectomy on May 19, 2015. The pathology revealed a pT4pN3 gastric adenocarcinoma. The patient became clinically stable and was discharged 10 days after surgery. He was subsequently started on adjuvant FOLFOX chemotherapy; however, 9 days after the second cycle, he was brought to the emergency room with nausea and severe epigastric pain. A CT scan revealed a hiatal hernia with signs of strangulation. The patient underwent emergent repair of the hernia and suffered no postoperative complications. He was discharged from the hospital 9 days after surgery. Conclusion: Hiatal hernia is not well documented, and its occurrence in the context of gastrectomy is an infrequent complication.

Familial Right Thoracic Stomach

PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 430-431
Author(s):  
BRUCE C. HUBERT ◽  
WILLIAM M. TOYAMA
Keyword(s):  
Gastric Mucosa ◽  
Hiatal Hernia ◽  
Medical Center ◽  
Case Reports ◽  
Progressive Increase ◽  
Esophageal Hiatus ◽  
Thoracic Cavity ◽  
Thoracic Stomach ◽  
Successive Generations ◽  
Dorsal Mesentery

Hiatal hernia reportedly occurs in about one in 1,000 infants.1 Failure of fusion of the dorsal mesentery and the developing stomach probably accounts for the widened esophageal hiatus. A continuum then exists that ranges from a small loculus of gastric mucosa in the chest (partial thoracic stomach) to a complete herniation of the stomach into the thoracic cavity. This abnormality has rarely been reported in infancy and, almost always, the hernia has been reported in the left thoracic cavity.2-4 A familial occurrence in infants in successive generations has never been previously reported. CASE REPORTS K.C., a 2-month-old white boy, was admitted to the Marshfield Medical Center because of a progressive increase in postprandial vomiting.

scholarly journals A Case of Ultrasound Diagnosis of Fetal Hiatal Hernia in Late Third Trimester of Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Stefania Di Francesco ◽  
Mariano Matteo Lanna ◽  
Marcello Napolitano ◽  
Luciano Maestri ◽  
Stefano Faiola ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Hiatal Hernia ◽  
Posterior Mediastinum ◽  
Cystic Mass ◽  
Esophageal Hiatus ◽  
Prenatal Counseling ◽  
Third Trimester ◽  
Postnatal Management ◽  
Abdominal Organs ◽  
Upper Gastrointestinal

Congenital hiatal hernia is a condition characterized by herniation of the abdominal organs, most commonly the stomach, through a physiological but overlax esophageal hiatus into the thoracic cavity. Prenatal diagnosis of this anomaly is unusual and only eight cases have been reported in the literature. In this paper we describe a case of congenital hiatal hernia that was suspected at ultrasound at 39 weeks’ gestation, on the basis of a cystic mass in the posterior mediastinum, juxtaposed to the vertebral body. Postnatal upper gastrointestinal tract series confirmed the prenatal diagnosis. Postnatal management was planned with no urgency. Hiatal hernia is not commonly considered in the differential diagnosis of fetal cystic chest anomalies. This rare case documents the importance of prenatal diagnosis of this anomaly for prenatal counseling and postnatal management.

scholarly journals Current Trends in Etiological Profile of Acute Upper Gastrointestinal Bleeding in Northern India: A Retrospective Analysis of 5-Year Endoscopic Data

2021 ◽  
Vol 12 (01) ◽  
pp. 031-035
Author(s):  
Vishal Bodh ◽  
Brij Sharma ◽  
Rajesh Kumar ◽  
Rajesh Sharma
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
The Other ◽  
Western India ◽  
Anastomotic Site ◽  
Care Hospital ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Etiological Spectrum ◽  
Upper Gastrointestinal

Abstract Introduction The etiological spectrum of acute upper gastrointestinal bleeding (AUGIB) varies from region to region. This study was performed to find out the latest etiological spectrum of the AUGIB in a tertiary care hospital in North India and to compare it with etiological spectra from a previous study from the same center and from the other regions of India. Methods Clinical notes and endoscopic data of all consecutive patients who had presented with AUGIB in Indira Gandhi Medical College Shimla, Himachal Pradesh, from May 2015 to December 2019, were analyzed retrospectively with the objective of finding out the various endoscopic etiologies that lead to AUGIB. The findings were compared with the previous study from the same center and with the data from the other regions of the country. Results A total of 1,513 patients were enrolled and majority were males (74.6%) with male:female ratio of 2.9:1. Majority were 41 to 60 years (46.46%) of age. Melena was the presenting complaint in 93.98% and hematemesis in 46.06%. Peptic ulcer disease (PUD; 46.19%) was the commonest cause of AUGIB followed by portal hypertension (26.23%). Other less common causes were erosive mucosal disease, erosive esophagitis, neoplasm, Mallory–Weiss tear, gastric angiodysplasia, anastomotic site ulcers, and Dieulafoy’s lesion. Conclusion PUD was still the commonest cause of AUGIB followed by portal hypertension. This is in agreement with the previous report from the same center and in contrast to the reports from other studies from Northern and Western India that create the impression that portal hypertension related bleeding is the most common cause of AUGIB in India.

Severe Referred Shoulder Pain Following Revision Fundoplication From a Stich on the Diaphragm

2021 ◽  
pp. 000313482110111
Author(s):  
Kevin J. Gale ◽  
Santana Sanchez ◽  
Thomas J. Sorenson ◽  
Todd D. Elftmann
Keyword(s):  
Hiatal Hernia ◽  
Shoulder Pain ◽  
Medical Management ◽  
Nissen Fundoplication ◽  
Left Shoulder ◽  
Toupet Fundoplication

Complications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the suture, resulting in resolution of the pain. This pain remained resolved at the most recent follow-up on postoperative week six, and the patient had no further concerns.

New Concept for a Thoracic Drainage System Using Magnetic Actuation

2019 ◽  
Vol 26 (6) ◽  
pp. 705-711
Author(s):  
Daisuke Taniguchi ◽  
Keitaro Matsumoto ◽  
Yoshihiro Kondo ◽  
Tomoshi Tsuchiya ◽  
Ikuo Yamamoto ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Drainage System ◽  
Magnetic Actuation ◽  
Thoracic Cavity ◽  
Common Procedure ◽  
Thoracic Drainage ◽  
Drain Fluid ◽  
Laboratory Trial ◽  
General Surgeons ◽  
Effective Drainage

Objectives. Thoracic drainage is a common procedure to drain fluid, blood, or air from the pleural cavity. Some attempts to develop approaches to new thoracic drainage systems have been made; however, a simple tube is often currently used. The existing drain presupposes that it is placed correctly and that the tip does not require moving after insertion into the thoracic cavity. However, in some cases, the drain is not correctly placed and reinsertion of an additional drain is required, resulting in significant invasiveness to the patient. Therefore, a more effective drainage system is needed. This study aimed to develop and assess a new thoracic drain via a collaboration between medical and engineering personnel. Methods. We developed the concept of a controllable drain system using magnetic actuation. A dry laboratory trial and accompanying questionnaire assessment were performed by a group of thoracic and general surgeons. Objective mechanical measurements were obtained. Porcine experiments were also carried out. Results. In a dry laboratory trial, use of the controllable drain required significantly less time than that required by replacing the drain. The average satisfaction score of the new drainage system was 4.07 out of 5, indicating that most of the research participants were satisfied with the quality of the drain with a magnetic actuation. During the porcine experiment, the transfer of the tip of the drain was possible inside the thoracic cavity and abdominal cavity. Conclusion. This controllable thoracic drain could reduce the invasiveness for patients requiring thoracic or abdominal cavity drainage.

scholarly journals Seasonal variation of the plerocercoid ligula intestinalis (L) observed in roach (Rutilus rutilus, L) from the yenice irrigation pond, Çanakkale, Turkey

2004 ◽  
Vol 58 (1-2) ◽  
pp. 127-133 ◽  
Author(s):  
Cemal Oguz ◽  
Öztürk Oguz ◽  
Hayati Güre
Keyword(s):  
Seasonal Variation ◽  
Parasite Species ◽  
Abdominal Cavity ◽  
Rutilus Rutilus ◽  
The Other ◽  
Host Fish ◽  
Roach Rutilus Rutilus ◽  
Mean Intensity ◽  
Ligula Intestinalis ◽  
Irrigation Pond

This study was carried out at the Yenice Irrigation Pond between October 1999 and October 2000. For this study 368 roach (Rutilus rutilus) were examined and 37 parasites and 93 Ligula intestinalis were found in the abdominal cavity of the host (prevalence 10.1%, mean intensity 2.51 specimens/fish). Based on season, the highest number of infected fish occurred during summer (33.3%, 4 parasite/fish), and during the other season the mean intensity of infection was relatively low (prevalence 3.3%, 1 specimens/fish). On the other hand, the parasite species was determined especially on small and medium host fish sizes (2.17-100%). Basic criteria for the assessment of the parasite species of host fish were the general parameters related to parasite populations, which are prevalence, mean intensity, seasonal variation, and relationship between host size and infection.

scholarly journals Sandifer Syndrome

2021 ◽  
Vol 3 (1) ◽  
pp. 30-32
Author(s):  
Juan Gomez
Keyword(s):  
Iron Deficiency ◽  
Gastroesophageal Reflux ◽  
Children And Adolescents ◽  
Hiatal Hernia ◽  
Iron Deficiency Anemia ◽  
Gastrointestinal Disorder ◽  
Deficiency Anemia ◽  
Neurological Manifestations ◽  
Upper Gastrointestinal

Sandifer syndrome, named after neurologist Paul Sandifer, was first reported by Marcel Kinsbourne in 1962, who noted an upper gastrointestinal disorder that occurs in children and adolescents with neurological manifestations. Sandifer syndrome is a neurobehavioral disorder that causes a series of paroxysmal dystonic movements in association with gastroesophageal reflux and, in some cases, with hiatal hernia. It is characterized by esophagitis, iron deficiency anemia, and is often mistaken for a seizure of epileptic origin.

Contribution of videothoracoscopy in the management of thoracic wounds with diaphragmatic lesions: A single African center experience

Trauma ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 142-147
Author(s):  
Sani Rabiou ◽  
Hicham Harmouchi ◽  
Marouane Lakranbi ◽  
Sani Rachid ◽  
Yassine Ouadnouni ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Stab Wound ◽  
Diaphragmatic Injury ◽  
The Other ◽  
Thoracic Cavity ◽  
Pulmonary Injury ◽  
Good View ◽  
Thoracic Drainage ◽  
Thoracic Lesion ◽  
Mini Thoracotomy

Background and aims The management of thoracic wounds induced by sharp objects outside an extreme emergency remains controversial. The means vary from exploratory thoracotomy to simple monitoring. Between these two extremes, videothoracoscopy as a means of exploration plays an important role and helps to avoid unnecessary thoracotomies, thus making it possible to make early diagnosis of diaphragmatic lesions. The aim of this study was to report our experience in videothoracoscopic management of thoracic wounds by penetrating objects. Material and methods From January 2010 to December 2015, 58 patients with an average age 22.5 years with a thoracic stab wound with a stable hemodynamic condition underwent videothoracoscopy. Results Thoracoscopy revealed a diaphragmatic injury in 17 patients, cardiac or pericardial wounds in four and a haemorrhagic pulmonary injury in 1; all were treated at video-assisted mini-thoracotomy. In the other 36 patients, videothoracoscopic exploration did not demonstrate any intra-thoracic lesion and the procedure consisted of aspiration of a residual hemothorax with the installation of a good view-controlled thoracic drainage. Hospital stay was between 48 and 72 h. Conclusion Videothoracoscopy is a safe and effective way to explore the thoracic cavity in patients with chest wounds with suspected diaphragmatic lesions. It avoids thoracotomy especially in hemodynamically stable patients.

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