Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Advances in Respiratory Medicine
MENU
Shortcuts Ahead Of Print Author statement Editorial Policy and Information for Authors Reviewers 2021

open access

Vol 87, No 1 (2019)
Case report
Submitted: 2018-10-27
Accepted: 2019-01-20
Published online: 2019-03-04
View PDF Download PDF file Supp./Additional Files [1]
Get Citation

Giant hiatal hernias

Jan Lesinski1, Tadeusz M Zielonka2, Olga Wajtryt1, Krystyna Peplinska3, Aleksandra Kaszynska1
DOI: 10.5603/ARM.a2019.0009
·
Pubmed: 30830959
·
Adv Respir Med 2019;87(1):54-62.
Affiliations
  1. Clinical Department of Internal Medicine, Czerniakowski Hospital in Warsaw, Stepinska 19/25, 00-739 Warsaw, Poland
  2. Departement of Family Medecine, Warsaw Medical University, Stepinska street 19/25, 00-739 Warsaw, Poland
  3. Department of Internal Medicine and Cardiology, Solec Hospital in Warsaw, Solce 93, 00-382 Warsaw, Poland

open access

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

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.

Full Text:

View PDF Download PDF file Supp./Additional Files [1]
Get Citation

Keywords

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

Supp./Additional Files (1)
Giant hiatal hernias. Fig 6
View
96KB
About this article
Title

Giant hiatal hernias

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 1 (2019)

Article type

Case report

Pages

54-62

Published online

2019-03-04

Page views

1181

Article views/downloads

1801

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

References (37)
  1. Chandrasekharan PK, Rawat M, Madappa R, et al. Congenital Diaphragmatic hernia - a review. Matern Health Neonatol Perinatol. 2017; 3: 6.
    CrossRefPubMed
  2. Torfs CP, Curry CJ, Bateson TF, et al. A population-based study of congenital diaphragmatic hernia. Teratology. 1992; 46(6): 555–565.
    CrossRefPubMed
  3. Horton JD, Hofmann LJ, Hetz SP. Presentation and management of Morgagni hernias in adults: a review of 298 cases. Surg Endosc. 2008; 22(6): 1413–1420.
    CrossRefPubMed
  4. Nursal TZ, Ugurlu M, Kologlu M, et al. Traumatic diaphragmatic hernias: a report of 26 cases. Hernia. 2001; 5(1): 25–29.
    PubMed
  5. Cortes M, Tapuria N, Khorsandi SE, et al. Diaphragmatic hernia after liver transplantation in children: case series and review of the literature. Liver Transpl. 2014; 20(12): 1429–1435.
    CrossRefPubMed
  6. Johnson DA, Ruffin WK. Hiatal hernia. Gastrointest Endosc Clin N Am. 1996; 6(3): 641–666.
    PubMed
  7. Kang JY. Systematic review: geographical and ethnic differences in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2004; 20(7): 705–717.
    CrossRefPubMed
  8. Dean C, Etienne D, Carpentier B, et al. Hiatal hernias. Surg Radiol Anat. 2012; 34(4): 291–299.
    CrossRefPubMed
  9. Maziak DE, Todd TR, Pearson FG. Massive hiatus hernia: evaluation and surgical management. J Thorac Cardiovasc Surg. 1998; 115(1): 53–60; discussion 61.
    PubMed
  10. Chory ET. Laparoscopic surgical treatment of paraesophageal hiatus hernia. J Lancaster General Hospital . 2007; 2(2): 56–59.
  11. Mitiek MO, Andrade RS. Giant hiatal hernia. Ann Thorac Surg. 2010; 89(6): S2168–S2173.
    CrossRefPubMed
  12. DeAlwis K, Mitsunaga EM. Sudden death due to nontraumatic diaphragmatic hernia in an adult. Am J Forensic Med Pathol. 2009; 30(4): 366–368.
    CrossRefPubMed
  13. Sihvo EI, Salo JA, Räsänen JV, et al. Fatal complications of adult paraesophageal hernia: a population-based study. J Thorac Cardiovasc Surg. 2009; 137(2): 419–424.
    CrossRefPubMed
  14. Yoshimura M, Nagahara A, Ohtaka K, et al. Presence of vertebral fractures is highly associated with hiatal hernia and reflux esophagitis in Japanese elderly people. Intern Med. 2008; 47(16): 1451–1455.
    PubMed
  15. Kusano M, Hashizume K, Ehara Y, et al. Size of hiatus hernia correlates with severity of kyphosis, not with obesity, in elderly Japanese women. J Clin Gastroenterol. 2008; 42(4): 345–350.
    CrossRefPubMed
  16. Fujimoto K. Review article: prevalence and epidemiology of gastro-oesophageal reflux disease in Japan. Aliment Pharmacol Ther. 2004; 20 Suppl 8: 5–8.
    CrossRefPubMed
  17. Loffeld RJ, Liberov B, Dekkers PEP. The changing prevalence of upper gastrointestinal endoscopic diagnoses: a single-centre study. Neth J Med. 2012; 70(5): 222–226.
    PubMed
  18. Furukawa N, Iwakiri R, Koyama T, et al. Proportion of reflux esophagitis in 6010 Japanese adults: prospective evaluation by endoscopy. J Gastroenterol. 1999; 34(4): 441–444.
    PubMed
  19. Cole TJ, Turner MA. Manifestations of gastrointestinal disease on chest radiographs. Radiographics. 1993; 13(5): 1013–1034.
    CrossRefPubMed
  20. Boushey RP, Moloo H, Burpee S, et al. Laparoscopic repair of paraesophageal hernias: a Canadian experience. Can J Surg. 2008; 51(5): 355–360.
    PubMed
  21. Higashi S, Nakajima K, Tanaka K, et al. Laparoscopic anterior gastropexy for type III/IV hiatal hernia in elderly patients. Surg Case Rep. 2017; 3(1): 45.
    CrossRefPubMed
  22. Le Page PA, Furtado R, Hayward M, et al. Durability of giant hiatus hernia repair in 455 patients over 20 years. Ann R Coll Surg Engl. 2015; 97(3): 188–193.
    CrossRefPubMed
  23. Tam V, Winger DG, Nason KS. A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair. Am J Surg. 2016; 211(1): 226–238.
    CrossRefPubMed
  24. Testini M, Girardi A, Isernia RM, et al. Emergency surgery due to diaphragmatic hernia: case series and review. World J Emerg Surg. 2017; 12: 23.
    CrossRefPubMed
  25. Magu S, Agarwal S, Singla S. Computed Tomography in the Evaluation of Diaphragmatic Hernia following Blunt Trauma. Indian J Surg. 2012; 74(4): 288–293.
    CrossRefPubMed
  26. Schuchert MJ, Adusumilli PS, Cook CC, et al. The impact of scoliosis among patients with giant paraesophageal hernia. J Gastrointest Surg. 2011; 15(1): 23–28.
    CrossRefPubMed
  27. Sánchez-Pernaute A, Talavera P, Pérez-Aguirre E, et al. Technique of Hill's Gastropexy Combined with Sleeve Gastrectomy for Patients with Morbid Obesity and Gastroesophageal Reflux Disease or Hiatal Hernia. Obes Surg. 2016; 26(4): 910–912.
    CrossRefPubMed
  28. Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999; 94(10): 2840–2844.
    CrossRefPubMed
  29. Thiam O, Konate I, Gueye ML, et al. Traumatic diaphragmatic injuries: epidemiological, diagnostic and therapeutic aspects. Springerplus. 2016; 5(1): 1614.
    CrossRefPubMed
  30. Lu J, Wang Bo, Che X, et al. Delayed traumatic diaphragmatic hernia: A case-series report and literature review. Medicine (Baltimore). 2016; 95(32): e4362.
    CrossRefPubMed
  31. Devbhandari MP, Khan MA, Hooper TL. Cardiac compression following cardiac surgery due to unrecognised hiatus hernia. Eur J Cardiothorac Surg. 2007; 32(5): 813–815.
    CrossRefPubMed
  32. Narala K, Banga S, Hsu M, et al. Hiatal hernia mimicking ST elevation myocardial infarction. Cardiology. 2014; 129(4): 258–261.
    CrossRefPubMed
  33. Harada K, Tamura U, Ichimiya C, et al. Left ventricular obstruction caused by a large hiatal hernia. Echocardiography. 2017; 34(8): 1254–1256.
    CrossRefPubMed
  34. Vanerio G. Syncope caused by huge hiatal hernia. Case Rep Cardiol. 2011; 2011: 560734.
    CrossRefPubMed
  35. Sontag SJ. The spectrum of pulmonary symptoms due to gastroesophageal reflux. Thorac Surg Clin. 2005; 15(3): 353–368.
    CrossRefPubMed
  36. Sahin C, Akın F, Cullu N, et al. A large intra-abdominal hiatal hernia as a rare cause of dyspnea. Case Rep Cardiol. 2015; 2015: 546395.
    CrossRefPubMed
  37. Wachsmann JW, Kim CK. V/Q matched defect larger than hiatal hernia itself. World J Nucl Med. 2015; 14(3): 202–204.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl