Chapter 35: Hernias- Esophageal; Type 1 (Sliding) Flashcards
1
Q
What is it?
A
Both the stomach and GE junction herniate into the thorax via the esophageal hiatus; also known as type I hiatal hernia
2
Q
What is the incidence?
A
>90% of all hiatal hernias
3
Q
What are the symptoms?
A
- Most patients are asymptomatic
- but the condition can cause:
- reflux
- dysphagia (from inflammatory edema)
- esophagitis
- pulmonary problems secondary to aspiration
4
Q
How is it diagnosed?
A
UGI series, manometry, esophagogastroduodenoscopy (EGD) with biopsy for esophagitis
5
Q
What is the treatment?
A
- 85% of cases treated medically with antacids, H2 blockers/PPIs, head elevation after meals, small meals, and no food prior to sleeping;
- 15% of cases require surgery for persistent symptoms despite adequate medical treatment
6
Q
What is the surgical treatment?
A
Laparoscopic Nissen fundoplication (LAP NISSEN) involves wrapping the fundus around the LES and suturing it in place