• Journal of Chest Surgery
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• 제34권2호
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• pp.184-188
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• 2001

선천성 횡경막탈장은 2000∼5000명의 신생아 당 한명 꼴의 발생율을 가진 드문 질환이다. 그 중 신생아에서 열공탈장은 더욱 희귀한 질환이다. 저자는 생후 1주일된 신생아의 선천성 복합열공탈장을 경험하였다. 진단은 빠른 시간내 이루어졌으며 수술은 우측 흉곽절제술을 통해 탈장된 장기를 복원하고 Belsey-mark IV 술식을 시행하였다. 환아는 술후 3일째 음식을 먹었고 퇴원 6개월후 지금까지 별 문제없이 잘 지내고 있다.

• Journal of Chest Surgery
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• 제42권1호
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• pp.115-118
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• 2009

중부 식도암에서 개흉적 식도절제술을 시행 받은 65세 남자가 식도열공 직상부의 좌측 종격 흉막이 찢어진 곳을 통해 횡행결장의 흉강내 탈장이 발생하였다. 단순흉부촬영상 좌측 하폐야에 공기음영의 누적이 발견되었고 이는 점차 진행하여 좌측 폐를 완전히 허탈시키고 혈역학적 불안정을 야기하였다. 식도절제술 후 생명을 위협하는 흉강내로의 탈장은 응급 개복술을 통하여 교정되었다. 식도절제술 후 식도열공을 통한 흉강내 탈장은 장의 폐색이나 꼬임의 위험 때문에 생명을 위협할 가능성이 있어 증상이 있는 환자에서 응급으로 복부절개를 통한 탈장의 수술적 복원을 시행하여야 한다. 하지만 식도절제술시 이러한 합병증의 예방을 위한 신중이 최우선일 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.211-216
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• 1999

식도열공 탈장은 그 형태에 따라 진단 및 치료가 지연될 경우 반복되는 구토, 빈혈, 영양실조, 출혈, 감돈, 위궤양, 급성 위팽만 등의 합병증이 발생하여 치명적일 수 있다. 저자들은 심한 탈수와 영양 실조를 주소로 내원한 10개월 남아에서 단순 흉부촬영에서 우측 흉부 종괴로 오인되었으나 선천성 식도열공 탈장과 위의 회전에 의해 상부 위장관 바륨조영술에서 우측 흉강내에 위가 위치한 것처럼 보였던 경우로 탈장 정복술과 위식도 역류방지술을 시행한 후 상기 증상이 호전된 제 3형의 선천성 식도열공 탈장 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제16권3호
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• pp.399-404
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• 1983

In general, hiatal hernia is rare incidence among diaphragmatic hernia in Korea especially in pediatric group. Recently great interest in hiatal hernia has not led to common agreement concerning the pathophysiology, method of diagnosis, clinical picture, Indications, and type of treatment. At 1981 and 1983, two cases of congenital hiatal hernia [type I, III] were surgically treated,which surgical Intervention was modified Hill`s operation and gastropexy. Postoperatively, clinical and radiological examination were proved no regurgitation, no dysphagia and well passage of barium.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제9권1호
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• pp.103-107
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• 2006

Belsey Mark IV 위바닥주름술은 이전의 역류 방지 수술이 실패하여 재수술을 해야 하는 경우 혹은 식도 열공 탈장이 오래 되어 유착이 있는 경우에 적응증이 된다. 본 증례는 식도 열공 탈장과 GERD로 진단되어 Nissen 위바닥 주름술을 시행하였으나 실패하였고 재수술을 시도하였지만 수술 부위의 유착이 심하여 수술적 접근이 불가능하였다. 저자들은 흉강을 통하여 Belsey Mark IV 위바닥주름술을 실시하였고, 수술 후 증상과 영양상태의 호전을 보인 1예를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1436-1439
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• 1992

Esophageal hiatal hernia is common disorder in western sociey, and mainly affects mid-aged women, There are two types of hiatal gernia; common and more benign type is sliding [type I], and more severe type is paraesophageal [type II], and Skinner subdivided type II as true II, IIA, III, and paraesophageal group, As Skinner`s nomination, this case could be belong to IIA, which imply the state that natural hiatus is occupied with gastric antrum or duodenum instead of normal esophago-gastric junction, Main problem of paraesophageal hernia comes from its complication; intestinal obstruction, volvulus, strangulation, and incarceration, as well as pulmonary aspiration. So, as soon as confirm diagnosis, it should be corrected surgically to prevent above complications, and sometimes it could result in serious condition. We have experienced paraesophageal hiatal hernia in 3-day newborn infant and have repaired it successfully. We used transabdominal approach to repair and to prevent reflux Nissen`s fundoplication was performed. We would report that with reference study.

• Journal of Chest Surgery
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• 제26권4호
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• pp.337-341
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• 1993

Since the first deliberate repair of hiatal hernia by Wm. J. Mayo in 1911, counterless procedure have been performed to correct herniation of the stomach into the posterior mediastinum. Recently,we experienced 51 years old female patient with large paraesophageal hernia and complete intrathoracic stomach which combined with multiple gastric erosion with chronic blood loss. So gastric ulcer within a diaphragmatic hernia is a distinct physiophathologic and clinical entity that our patient suffered from severe anemia due to chronic blood loss. The hernia was repaired transabdominally including reduction of stomach, excision of sac, closure of defect, anterior gastropexy, and gastr6stomy. Because of absent gastroesophageal refiux, no another antireflux procedure was required and erosion was managed by H2 receptor blocker.

• Journal of Chest Surgery
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• 제28권11호
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• pp.1067-1070
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• 1995

We experienced a case of congenital paraesophageal hiatal hernia[Type;IV in seventeen day-old female and treated through the right thoracotomy, reduction of the herniated viscera ,stomach and some part of transverse colon and omentum by gentle finger push, and narrowing the esopahgeal hiatus. Paraesophageal hiatal hernia accounts for only 5% per cent of all diaphragmatic defects but is a potentially dangerous lesion due to compressed lung by the herniated viscera. Symptoms are related to this, including exertional dyspnea, vomiting, cough, Tachypnea but noncyanotic, etc. Barium study shows that the stomach has herniated into the right pleural cavity. The speckled appearance in the herniated stomach in the herniated stomach was due to food material. It strongly suggests paraesophageal hiatal hernia. The operation was done. We report the case with the brief review of literatures.

• 대한한방내과학회지
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• 제38권3호
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• pp.401-407
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• 2017

Objective: This study reports on a treatment case of Soojeom-san plus Jeungmiyijin-tang (SJJI) on gastroesophageal reflux disease with hiatal hernia. Method: We considered a male patient suffering from gastroesophageal reflux disease with hiatal hernia because of blood stasis and damp-heat of the spleen and stomach pattern and prescribed SJJI. The progress was evaluated using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) score, and the visual analogue scale for abdominal pain, sore stomach, and other symptoms. Results: The patient's symptoms, which included abdominal pain, sore stomach, dyspepsia, anorexia, insomnia, etc., almost disappeared. Conclusion: SJJI can be used for patients who have a chronic condition of gastroesophageal reflux disease with hiatal hernia because of blood stasis and a pattern of damp-heat of the spleen and stomach.

• Journal of Chest Surgery
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• 제27권1호
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• pp.72-75
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• 1994

The esophageal hiatal hernia is a rare disease in Korea especially in children and infant. We experienced a case of type III esophageal hiatal hernia in 9 months female. She had no specific past history and familial history except recurrent URI and postprandial habitual vomiting. The chest X-ray and Barium swallowing showed herniated stomach in Rt. thoracic cavity and posterior mediastinum. We performed modified Belsey Mark IV procedure with using the 3-0 and 4-0 Pledgeted Ticrons. In operative field, the stomach cardia portion was herniated into the Rt.thoracic cavity and posterior mediastinum with elevation of the esophagogastric junction above the diaphragm. But there was no evidence of short esophagus and combined anomaly. The postoperative courses were uneventful and good without specific complication for about 5 months to this point.