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. 2018 Mar 16;6(2):171-175.
doi: 10.14744/nci.2018.58672. eCollection 2019.

Congenital hiatus hernia: A case series

Didem Baskin Embleton  1 , Ahmet Ali Tuncer  1 , Mehmet Surhan Arda  2 , Huseyin Ilhan  2 , Salih Cetinkursun  1
Affiliations

Congenital hiatus hernia: A case series

Didem Baskin Embleton et al. North Clin Istanb. .

Abstract

Objective: Hiatus hernia is frequent in adults and rare in children; congenital hiatus hernia is even rarer. In this study, we describe a group of infants with congenital hiatus hernia and discuss its management.

Methods: Records of patients (male: 3, female: 4) who were diagnosed with congenital hiatus hernia between 2010 and 2016 were extracted. Demographic data, presenting symptoms, diagnostic investigations, operative details, postoperative follow-up, and early and late postoperative complications were evaluated retrospectively.

Results: Four patients were female and three were male. One patient was diagnosed prenatally while the mean age at diagnosis for others was 18.6 months. Four patients had type IV hernia, 2 had type III hernia, and one had type I hernia. The diagnosis was confirmed by chest X-ray, computerized tomography (CT) and/or upper gastrointestinal series. The hiatal repair was done in all patients either by laparotomy or laparoscopy. During the procedure, 2 patients had Nissen fundoplication and 3 patients had Thal fundoplication. Recurrence of hernia occurred in the 2 patients who had Thal fundoplication.

Conclusion: Recurrence of sliding hernias with Thal fundoplication seem more frequent in the series. If the esophagogastric junction is present in the thorax, mediastinal dissection of the esophagus may be required to achieve a good abdominal esophagus structure, which will prevent a recurrence.

Keywords: Congenital; Nissen fundoplication; Thal fundoplication; hiatus hernia; short esophagus.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

FIGURE 1
FIGURE 1
(A) A-P chest X-ray of patient 4 showing a slightly median air-fluid level on the right hemithorax. Gastric air is absent in its usual location. (B) Lateral chest X-ray of the same patient showing that the air-fluid level is placed posteriorly. This patient had a type IV hernia.
FIGURE 2
FIGURE 2
(A) A-P chest X-ray of patient 1 showing mid-thoracic air locules resembling intestinal gas. Gastric air is not seen at its usual location. The lesion looks like a Morgagni hernia. (B) Computerized tomography of the same patient shows posteriorly placed diaphragmatic defect which includes intestinal structures. This patient had a type IV hernia.
FIGURE 3
FIGURE 3
Upper gastrointestinal series of patient 2 showing thoracic replacement of gastric fundus from a medial diaphragmatic defect. This patient had a type I hernia.
See this image and copyright information in PMC

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