• Title/Summary/Keyword: hiatal hernia

Search Result 42, Processing Time 0.035 seconds

Laparoscopic Hiatal Hernia Repair and Roux-en-Y Conversion for Refractory Duodenogastroesophageal Reflux after Billroth I Distal Gastrectomy

  • Park, Joong-Min;Yoon, Sung Jin;Kim, Jong Won;Chi, Kyong-Choun
    • Journal of Gastric Cancer
    • /
    • v.20 no.3
    • /
    • pp.337-343
    • /
    • 2020
  • Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.

Surgical Treatment of Sliding Hiatal Hernia by Incisional Gastropexy at Fundus and Pylorus in a Chihuahua Dog (치와와견에서 위저부 및 유문부의 절개성 위고정술을 통한 축성열공허니아의 수술적 치료)

  • Jang Ha-young;Yoon Hun-young;Kim Jun-young;Han Hyun-jung;Jeong Soon-wuk
    • Journal of Veterinary Clinics
    • /
    • v.22 no.1
    • /
    • pp.76-78
    • /
    • 2005
  • A 1 year 2 months old, male Chihuahua dog weighing 0.92 kg was presented with a history of intermittent vomiting after eating since two weeks ago. Based on the history, clinical signs, physical examination, and contrast radiographs, the diagnosis of sliding hiatal hernia was made. Diaphragmatic plication, esophagopexy and left-sided gastropexy concurrently required for surgical correction but in this case, diaphragmatic plication and esophagopexy could not be applied because of the patient's special condition. Instead, left-sided gastropexy was performed with additional pyloropexy. To treat reflux esophagitis, cimetidine and sucralfate were administrated and patient was fed in an upright position. Two days after the surgery, the patient showed normal activity and after then there was not found recurrence or complication.

Diaphragmatic Hernia: Report of 20 Cases (횡경막 허니아)

  • Jo, Gyu-Seok;Cho, Bum-Koo;Hong, Seung-Nok
    • Journal of Chest Surgery
    • /
    • v.11 no.4
    • /
    • pp.433-440
    • /
    • 1978
  • Congenital diaphragmatic hernia is an important cause of respiratory distress in the newborn. Eventration, with which these conditions are easily confused, may also Produce severe respiratory distress in infancy or be an asymptomatic radiographic finding. Harrington`s classification of diaphragmatic hernias into two categories, traumatic and nontraumatic, is most widely accepted. Nontraumatic hernias are [1] the congenital types, composed of the posterolateral [Bochdalek], those through the esophageal hiatus, the parasternal [/Morgagni], and those through a defect left by partial absense posteriorly, and [2] the acquired types, composed of those through the esophagea/hiatus [sliding and paraesophageal] and those the sites mentioned above under the congenital hernias. During the period from 1970 up to October 1978, 21 cases of diaphragmatic hernia were treated in department of cardiovascular and thoracic surgery. 11 cases of Bochdalek hernias, 1 case of Morgagni hernia, 5 cases of diaphragmatic eventration and 3 cases of hiatal hernia [2 cases of paraesophageal and 1 cases of sliding type], were experienced. 3 cases of 20 died of respiratory insufficiency, 2 cases of mortality were combined with left lung hypoplasia with Bochdalek hernia.

  • PDF

Hiatal Hernia in Neonate (신생아의 식도 열공 탈장)

  • 임용택;정승혁;김민용;김병열;이정호
    • Journal of Chest Surgery
    • /
    • v.34 no.2
    • /
    • pp.184-188
    • /
    • 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.

  • PDF

A Case Report of Gastroesophageal Reflux Disease(GERD) with Hiatal Hernia (식도열공탈장을 동반한 위식도 역류성 질환 환자 치험 1례)

  • Park, Jung-Han;Cho, Hyun-Seok;Kim, Jung-Chul;Oh, Sung-Won;Lee, Sang-Hoon;Kim, Byoung-Woo;Lee, Jae-Eun
    • The Journal of Internal Korean Medicine
    • /
    • v.26 no.1
    • /
    • pp.244-251
    • /
    • 2005
  • Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. It causes various symptoms(heart bum, chest pain, dysphagia, vomiting etc.) when it is associated with a condition called gastroesophageal reflux disease(GERD). In this occasion, complications included bleeding because of the erosion, ulceration and inflammation of the mucosa. For treatment, there are $H_2$ blockers and proton pump inhibitors, but they have many side effects. In Oriental Medicine effectively treated cases are rare. Therefore, it is essential to seek radical agents and effective treatments for these disorders. In this case report, these disorders are approached by focusing on the deficit of 'yin(陰)'especially 'pi-yin(脾陰)'. Desired results were seen with herbal medications which enhance the 'yin(陰)', especially through 'wuyin-jian(五陰煎)' which enhances the 'pi-yin(脾陰)'. This is reported to contribute to development of future treatments.

  • PDF

A Case of Belsey Mark IV Fundoplication after Failed Nissen Antireflux Surgery (실패한 Nissen 술을 Belsey Mark IV 위바닥주름술로 교정한 1예)

  • Shon, Su Min;Shin, Hyun Jung;Park, Moon Ho;Keum, Dong Yoon;Park, Chang Kwon;Choi, Won Joung;Kim, Ae Suk;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.9 no.1
    • /
    • pp.103-107
    • /
    • 2006
  • Antireflux surgery has been indicated in gastroesophageal reflux disease (GERD) that does not respond to medical treatments. Although the most commonly performed operation is Nissen fundoplication, Belsey Mark IV fundoplication is indicated for more complicated cases, such as, in cases of a failed Nissen operation or a long lasting hiatal hernia. Here, we report a case of Belsey Mark IV fundoplication for a failed Nissen fundoplication. The infant developed frequent times of aspiration pneumonia after initial Nissen for a hiatal hernia with GERD during the newborn period. At 15 months of age, a $2^{nd}$ Nissen operation was attempted, but fundoplication was not available because of excessive mesenteric adherence to the liver and cardia. Therefore, Belsey Mark IV fundoplication was performed via trans-thoracic approach, which can provide full esophageal mobilization and better visualization of the herniated fundus and the surrounding tissues. Subsequently, she has shown an improved general condition without GERD.

  • PDF

Giant paraesophageal hiatus hernia associated with severe anemia [Belsy mark V procedure] (심한 빈혈증상을 동반한 거대한 식도주위허니아 치험 1예 (Belsey Mark V 수술치험))

  • 이두연
    • Journal of Chest Surgery
    • /
    • v.17 no.1
    • /
    • pp.150-156
    • /
    • 1984
  • Paraesophageal hiatus hernia represents a rare hiatal hernia that are treated surgically. The completely asymptomatic paraesophageal hernia often does not reach the clinician or surgeon. But the presence of a symptomatic paraesophageal hernia is sufficient indication for surgery. The paraesophageal hernia may be approached either transthoracically or transabdominally. The general technique is essentially the same, whichever route is used. From either transthoracic or transabdominal approach, following reduction of the viscus and elimination of the sac, the diaphragmatic opening is then closed with interrupted heavy dacron or silk sutures in paraesophageal hiatus hernia. But if the phrenoesophageal membrane often is destroyed when the esophagogastric junction and the distal esophagus have been mobilized, it becomes important to fix the esophagogastric junction below the diaphragm, so that it does not slide through the hiatus and produce a sliding-type hiatus hernia in future. We have experienced one case of paraesophageal hiatus hernia which was accompanied with severe anemia in child. We preferred to approach through left thoracotomy incision and then pushed down the stomach into the abdominal cavity with complete excision of the hernial sac. We employed Belsey Mark V procedure using of Teflon felt pledgets with the mattress sutures against development of sliding-type hiatus hernia in postoperative period. postoperative course has been uneventful and good for about 3 months to this time.

  • PDF

Clinical Analysis of the Belsey Mark IV Operation in Hiatal Hernia with Gastroesophageal Reflux and Achalasia (위 식도 역류를 가진 열공 헤르니아 환자와 식도 무이완증 환자에서 시행한 Belsey Mark IV 수술의 임상적 고찰)

  • 최영호;조원민;류세민;황재준;손영상;김학제;김광택
    • Journal of Chest Surgery
    • /
    • v.35 no.3
    • /
    • pp.217-222
    • /
    • 2002
  • Background: The incidence of gastroesophageal reflux disease(GERD) is increasing recently, but medical management for GERD has many limitations. Therefore, variable surgical treatments have been introduced. Material and Method: A retrospective study was done in 10 patients who underwent the Belsey Mark IV operation at Korea university Guro hospital between 1996 and 2001. Preoperative diagnoses were hiatal hernia with gasroesophageal reflux in 8 patients and achalasia in 2 patients. Result: Mean age of the patients was 54.3$\pm$19.0 years. Belsey Mark IV operation was performed on patients where preoperative medical failed and mean hospital days were 13.1$\pm$2.6 days. We routinely practiced follow-up endoscopy on postoperative 3rd, 6th, 9th, and 12th months. After remission for reflux and esophagitis, they were transferred to internal medicine department. Six patients of hiatal hernia with reflux (one patient who lost follow-up and the other patient who didn't practice the follow-up endoscopy due to short postoperative follow-up period were excluded) had lowered endoscopic gradings and two patients of achalasia did not complained of reflux symptoms, postoperatively. We experienced 10% operation failure rate. Conclusion: We experienced satisfactory operation results with Belsey Mark IV in hiatal hernia with GERD and achalasia patients.

Antireflux Surgery (위식도역류질환의 수술)

  • Na, Kook-Joo
    • Korean Journal of Bronchoesophagology
    • /
    • v.16 no.2
    • /
    • pp.105-108
    • /
    • 2010
  • The prevalence of gastroesophageal reflux disease(GERD) has been increased recently in Korea. Most patients who have GERD are well treated by medication. But patients who have suboptimal disease control under medical therapy are needed further treatment. Nowadays minimally invasive surgery using laparoscopy and thoracoscopy has become popular in the operation of GERD although antireflux surgery is vary. Antireflux surgery is a well-documented, effective therapeutic alternative to control GERD.

  • PDF