Observations on the treatment and course of 34 patients with esophageal hiatus hernia seen at the Babies Hospital in New York between 1943 and 1963 have been reviewed. These patients, ranging from birth to 12 years of age when first seen, presented symptoms of vomiting in the first weeks or months of life in the majority of cases. Sixteen were treated without operation (5 being asymptomatic). Twelve of these had good or fair results; 2 died.
Eighteen were treated surgically, twenty-three operations being performed. Results are not comparable, since those surgically treated represent, in general, patients in whom the diagnosis was made too late for effective non-surgical treatment. Fifteen obtained good results, seven by simple transthoracic repair and eight following esophagectomy. Five operations failed, requiring reoperation. There were two deaths.