open access

Vol 87, No 1 (2019)
CASE REPORTS
Published online: 2019-03-04
Submitted: 2018-10-27
Accepted: 2019-01-20
Get Citation

Giant hiatal hernias

Jan Lesinski, Tadeusz M Zielonka, Olga Wajtryt, Krystyna Peplinska, Aleksandra Kaszynska
DOI: 10.5603/ARM.a2019.0009
·
Pubmed: 30830959
·
Adv Respir Med 2019;87(1):54-62.

open access

Vol 87, No 1 (2019)
CASE REPORTS
Published online: 2019-03-04
Submitted: 2018-10-27
Accepted: 2019-01-20

Abstract

Dyspnoea is most often caused by disorders of the respiratory and/or cardiovascular systems. Much less often it is brought about
by the displacement of abdominal organs into the thoracic cage. Hiatal hernias may give rise to diagnostic difficulties, as both
clinical and radiological symptoms suggest different disorders. Computed tomography is the method of choice when making
a diagnosis.
We have presented a series of 7 cases of giant hiatal hernias, each with a varying course of the disease, clinical symptoms,
radiological features and prognoses.
In two of the cases, the hernias were of a post-traumatic nature. Four cases of large diaphragmatic hernias were found in elderly
patients (over 90 years old). An advanced age and numerous coexisting chronic diseases disqualified most of the patients from
surgical treatment despite the hernias’ large sizes. In only one case was fundoplication performed with a good end result. Two
patients died, and an extensive hernia was the cause of one of the deaths. Upper gastrointestinal symptoms were present only
in a few of the patients.
An early diagnosis of giant hiatal hernia is crucial for the patients to undergo prompt corrective surgeries.

Abstract

Dyspnoea is most often caused by disorders of the respiratory and/or cardiovascular systems. Much less often it is brought about
by the displacement of abdominal organs into the thoracic cage. Hiatal hernias may give rise to diagnostic difficulties, as both
clinical and radiological symptoms suggest different disorders. Computed tomography is the method of choice when making
a diagnosis.
We have presented a series of 7 cases of giant hiatal hernias, each with a varying course of the disease, clinical symptoms,
radiological features and prognoses.
In two of the cases, the hernias were of a post-traumatic nature. Four cases of large diaphragmatic hernias were found in elderly
patients (over 90 years old). An advanced age and numerous coexisting chronic diseases disqualified most of the patients from
surgical treatment despite the hernias’ large sizes. In only one case was fundoplication performed with a good end result. Two
patients died, and an extensive hernia was the cause of one of the deaths. Upper gastrointestinal symptoms were present only
in a few of the patients.
An early diagnosis of giant hiatal hernia is crucial for the patients to undergo prompt corrective surgeries.

Get Citation

Keywords

acquired diaphragmatic hernia, dyspnoea, elderly patients, gastroesophageal reflux disease, kyphoscoliosis, hiatal hernia

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About this article
Title

Giant hiatal hernias

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 1 (2019)

Pages

54-62

Published online

2019-03-04

DOI

10.5603/ARM.a2019.0009

Pubmed

30830959

Bibliographic record

Adv Respir Med 2019;87(1):54-62.

Keywords

acquired diaphragmatic hernia
dyspnoea
elderly patients
gastroesophageal reflux disease
kyphoscoliosis
hiatal hernia

Authors

Jan Lesinski
Tadeusz M Zielonka
Olga Wajtryt
Krystyna Peplinska
Aleksandra Kaszynska

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