小児期の傍食道裂孔ヘルニア

概要

論文の詳細を見る
The results of surgical repair of paraesophageal hiatus hernia in six children aged from 9 months to seven years old were analyzed. They had no associated conditions. Postprandial borborygmus in thorax was audible in all, and anemia was detected in three. Hiatus hernia was found incidentally in a case on a chest X ray for an other indication. The diagnosis of paraesophageal hiatus hernia was established by barium swallow and endoscopy. More than half of the stomach had herniated in all patients, and a portion of the transverse colon in two. A posterior crural repair was employed in all children, and Nissen fundoplication was added also in two. Two months after surgery, a mixed typed hiatus hernia recurred in a child who underwent crural repair only. Crural repair was performed again transthoraxically in this case. They have been followed up for an average of six years, and they have been leading a normal school life. An addition of the antireflux procedure, especially Nissen fundoplication, is controversial. Because gastroesophageal reflux is rare and not severe in paraesophageal hiatus hernia. Antireflux procedure, however, should be added to surgical correction of the anatomic defect, if evidence of gastroesophageal reflux is present or lower esophagus is mobilized extensively for the purpose to remove large hernia sac and to repair the crus posteriorly.
日本小児外科学会の論文
1992-12-20