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

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2
Q

What is the incidence?

A

>90% of all hiatal hernias

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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
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4
Q

How is it diagnosed?

A

UGI series, manometry, esophagogastroduodenoscopy (EGD) with biopsy for esophagitis

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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
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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

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