The frequency of true short oesophagus in type II–IV hiatal hernia

Abstract Purpose To assess the esophagogastric junction (EGJ) on real-time MRI and compare imaging parameters to EGJ morphology on high-resolution manometry (HRM). Methods A total of 105 of 117 eligible patients who underwent real-time MRI and high-resolution manometry for GERD-like symptoms between 2015 and 2018 at a single center were retrospectively evaluated (male n = 57; female n = 48; mean age 52.5 ± 15.4 years). Real-time MRI was performed at a median investigation time of 15 min (1 frame/40 ms). On HRM, EGJ morphology was assessed according to the Chicago classification of esophageal motility disorders. Real-time MRI was performed at 3 T using highly undersampled radial fast low-angle shot acquisitions with NLINV image reconstruction. A 10 mL pineapple juice bolus served as oral contrast agent at supine position. Real-time MRI films of the EGJ were acquired during swallowing events and during Valsalva maneuver. Anatomic and functional MRI parameters were compared to EGJ morphology on HRM. Results On HRM, n = 42 patients presented with EGJ type I (40.0%), n = 33 with EGJ type II (31.4%), and n = 30 with EGJ type III (28.6%). On real-time MRI, hiatal hernia was more common in patients with EGJ type III (66.7%) than in patients with EGJ type I (26.2%) and EGJ type II (30.3%; p < 0.001). Sliding hiatal hernia was more frequent in patients with EGJ type II (33.3%) than in patients with EGJ type III (16.7%) and EGJ type I (7.1%; p = 0.017). The mean esophagus–fundus angle of patients was 85 ± 31° at rest and increased to 101 ± 36° during Valsalva maneuver. Conclusion Real-time MRI is a non-invasive imaging method for assessment of the esophagogastric junction. Real-time MRI can visualize dynamic changes of the EGJ during swallowing events.

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Results of left thoracoscopic Collis gastroplasty with laparoscopic Nissen fundoplication for the surgical treatment of true short oesophagus in gastro-oesophageal reflux disease and Type III–IV hiatal hernia

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezv381 ◽

2015 ◽

Vol 49 (1) ◽

pp. e22-e30 ◽

Cited By ~ 7

Author(s):

Marialuisa Lugaresi ◽

Benedetta Mattioli ◽

Ottorino Perrone ◽

Niccolò Daddi ◽

Massimo Pierluigi Di Simone ◽

...

Keyword(s):

Surgical Treatment ◽

Hiatal Hernia ◽

Reflux Disease ◽

Nissen Fundoplication ◽

Laparoscopic Nissen Fundoplication ◽

Oesophageal Reflux ◽

Type Iii ◽

Collis Gastroplasty ◽

Short Oesophagus ◽

Laparoscopic Nissen

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Hiatal Hernia and Short Oesophagus in Children

Thorax ◽

10.1136/thx.6.1.56 ◽

1951 ◽

Vol 6 (1) ◽

pp. 56-70 ◽

Cited By ~ 23

Author(s):

E. Husfeldt ◽

G. Thomsen ◽

E. Wamberg

Keyword(s):

Hiatal Hernia ◽

Short Oesophagus

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Paraesophageal Hernia as a Cause of Chronic Asymptomatic Anemia in a 6 Years Old Boy; Case Report and Review of the Literature

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.97 ◽

2017 ◽

Vol 60 (2) ◽

pp. 76-81

Author(s):

Dimitrios Patoulias ◽

Maria Kalogirou ◽

Thomas Feidantsis ◽

Ignatios Kallergis ◽

Ioannis Patoulias

Keyword(s):

Hiatal Hernia ◽

Paraesophageal Hernia ◽

Esophageal Hiatus ◽

Type Ii ◽

Hernia Sac ◽

Esophageal Hiatal Hernia ◽

Type Iv ◽

Abdominal Organs ◽

Total Fundoplication ◽

Sliding Hiatal Hernia

Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Four types are identified: type Ι or sliding hiatal hernia, type II or paraesophageal hernia (PEH), type III or mixed hernia and type IV. Congenital type II esophageal hiatal hernia is caused by a remaining gap after the formation of pleuroperitoneal membrane. We present a case of a six years old boy admitted to our department, appearing with asymptomatic anemia, who was incidentally diagnosed with Type II esophageal hiatal hernia. After diagnostic investigation, the prolapsing stomach pouch was reduced, the hernia sac was excised, the crura of diaphragm were converged and a total fundoplication was performed, via open method. The patient had an uncomplicated postoperative period. We conclude that: 1) esophageal hiatal hernia should be included within diagnostic approach of a child with chronic non-hereditary anemia, 2) after a Type II esophageal hiatal hernia is diagnosed, a hernia repair surgery is indicated in short time, due to the severity of possible complications and 3) through the performance of total fundoplication, it is secured that the subdiaphragmatic abdominal part of esophagus will be retained, preventing the development of post-operative gastroesophageal reflux disease.

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Congenital Paraesophageal Hernia in a Cat

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6148 ◽

2015 ◽

Vol 51 (4) ◽

pp. 252-255 ◽

Cited By ~ 1

Author(s):

Kim Tong ◽

Reunan Guillou ◽

Doc Vét

Keyword(s):

Hiatal Hernia ◽

Mass Effect ◽

Acute Onset ◽

Type Ii ◽

Complex Type ◽

Palpable Mass ◽

Left Limb ◽

Paradoxical Breathing ◽

Paraesophageal Hiatal Hernia ◽

Entire Stomach

ABSTRACT A 3 mo old male domestic shorthair weighing 2 kg was presented for acute onset of anorexia, lethargy, paradoxical breathing, and a palpable mass effect in the cranial abdomen. Initial diagnostics and imaging suggested a pleuroperitoneal or hiatal hernia. Emergency abdominal exploration was performed, and a complex type II paraesophageal hiatal hernia was identified. The entire stomach, greater and lesser omenta, spleen, left limb of the pancreas, and the proximal segment of the descending duodenum were herniated through a discrete defect in the phrenicoesophageal ligament. After reduction of the herniated organs back into the abdomen, a phrenicoplasty, esophagopexy, and left-sided fundic gastropexy were performed. The cat recovered uneventfully from the procedure and was free of any signs of disease for at least 30 mo postoperatively. This is the first detailed report of the findings and successful surgical treatment of a complex congenital, type II paraesophageal hiatal hernia with complete herniation of the stomach, omenta, and spleen in a cat.

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Type II Solar Radio Bursts over Solar Cycle 21

International Astronomical Union Colloquium ◽

10.1017/s025292110002546x ◽

1994 ◽

Vol 144 ◽

pp. 283-284

Author(s):

G. Maris ◽

E. Tifrea

Keyword(s):

Solar Radio ◽

Interplanetary Space ◽

Impulsive Phase ◽

Radio Bursts ◽

Type Ii ◽

Solar Radio Bursts ◽

Strong Energy ◽

Mass Ejection ◽

Geophysical Effect ◽

Radio Event

The type II solar radio bursts produced by a shock wave passing through the solar corona are one of the most frequently studied solar activity phenomena. The scientific interest in this type of phenomenon is due to the fact that the presence of this radio event in a solar flare is an almost certain indicator of a future geophysical effect. The origin of the shock waves which produce these bursts is not at all simple; besides the shocks which are generated as a result of a strong energy release during the impulsive phase of a flare, there are also the shocks generated by a coronal mass ejection or the shocks which appear in the interplanetary space due to the supplementary acceleration of the solar particles.

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Heat-Etching with a Bullivant Type II Simple Freeze-Cleave Device

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100067522 ◽

1970 ◽

Vol 28 ◽

pp. 106-107 ◽

Cited By ~ 1

Author(s):

Ronald S. Weinstein ◽

N. Scott McNutt

Keyword(s):

New Zealand ◽

General Hospital ◽

Massachusetts General Hospital ◽

Type I ◽

Type Ii ◽

Collaborative Effort ◽

Temperature And Pressure ◽

The University

The Type I simple cold block device was described by Bullivant and Ames in 1966 and represented the product of the first successful effort to simplify the equipment required to do sophisticated freeze-cleave techniques. Bullivant, Weinstein and Someda described the Type II device which is a modification of the Type I device and was developed as a collaborative effort at the Massachusetts General Hospital and the University of Auckland, New Zealand. The modifications reduced specimen contamination and provided controlled specimen warming for heat-etching of fracture faces. We have now tested the Mass. General Hospital version of the Type II device (called the “Type II-MGH device”) on a wide variety of biological specimens and have established temperature and pressure curves for routine heat-etching with the device.

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Ultrastructure of pulmonary microvasculature in acute endotoxemia

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100083217 ◽

1978 ◽

Vol 36 (2) ◽

pp. 470-471

Author(s):

R. G. Gerrity ◽

M. Richardson

Keyword(s):

Polymorphonuclear Leukocytes ◽

Alveolar Epithelium ◽

Endothelial Damage ◽

Capillary Endothelium ◽

Type Ii Cells ◽

Type Ii ◽

Interstitial Edema ◽

Pulmonary Capillaries ◽

Lung Ultrastructure ◽

Fibrin Thrombi

Dogs were injected intravenously with E_. coli endotoxin (2 mg/kg), and lung samples were taken at 15 min., 1 hr. and 24 hrs. At 15 min., occlusion of pulmonary capillaries by degranulating platelets and polymorphonuclear leukocytes (PML) was evident (Fig. 1). Capillary endothelium was intact but endothelial damage in small arteries and arterioles, accompanied by intraalveolar hemorrhage, was frequent (Fig. 2). Sloughing of the surfactant layer from alveolar epithelium was evident (Fig. 1). At 1 hr., platelet-PML plugs were no longer seen in capillaries, the endothelium of which was often vacuolated (Fig. 3). Interstitial edema and destruction of alveolar epithelium were seen, and type II cells had discharged their granules into the alveoli (Fig. 4). At 24 hr. phagocytic PML's were frequent in peripheral alveoli, while centrally, alveoli and vessels were packed with fibrin thrombi and PML's (Fig. 5). In similar dogs rendered thrombocytopenic with anti-platelet serum, lung ultrastructure was similar to that of controls, although PML's were more frequently seen in capillaries in the former (Fig. 6).

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Mitochondria microcrystals deposition in some inherited diseases of lipid metabolism.

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100082145 ◽

1978 ◽

Vol 36 (2) ◽

pp. 256-257

Author(s):

S. Laoussadi ◽

A. Kahan ◽

G. Aubouy ◽

F. Delbarre

Keyword(s):

Synovial Tissue ◽

Storage Disease ◽

Metabolic Diseases ◽

Uranyl Acetate ◽

List Type ◽

Type Ii ◽

Type Number ◽

Lipid Storage Disease ◽

Thin Sections ◽

Mean Size

Several patients with Fabry's, Gaucher's diseases and hyperlipoproteinemia type II and with arthropatic manifestations were observed.As no histological explanation for these symptoms was available,an ultrastructural study of synovial tissue was done to establish an anatomoclinical relation.Material and Methods :synovial membrane samples were obtained by needle biopsies of the knee from three patients with arthropatic manifestations of each disease.They were fixed in 5% glutaraldehyde, postfixed in 1% osmium tetraoxyde and embedded in Epon 812. Thin sections coloured by uranyl acetate and lead citrate were observed with an Elmiskop I Siemens electron microscope.Two important phenomena were observed in synovial tissue:Specific patterns of each lipid storage disease,which are now well known.In all the three metabolic diseases, hydroxyapatite-like crystals were found. They are characterized by their intramitochondrial localization, without any relation with cristae,an anarchic disposition and a mean size of 550 A.Crystals may be found also free in the cytoplasm of synoviocytes Some micrographs suggest an evolution in four steps :a. mitochondria with only a few microcrystalsb. mitochondria stuffed with these structuresc. disruption of mitochondria membranesd. microcrystals appear free in the cytoplasm

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