Congenital hiatus hernia: A case series

INTRODUCTION: Hiatus hernia is frequent in adults and rare in children; congenital hiatus hernia is even rarer. In this study, we describe a group of infants with congenital hiatus hernia and discuss its management.
METHODS: Records of patients (male: 3, female: 4) who were diagnosed with congenital hiatus hernia between 2010 and 2016 were extracted. Demographic data, presenting symptoms, diagnostic investigations, operative details, postoperative follow-up, and early and late postoperative complications were evaluated retrospectively.
RESULTS: Four patients were female and three were male. One patient was diagnosed prenatally while the mean age at diagnosis for others was 18.6 months. Four patients had type IV hernia, 2 had type III hernia, and one had type I hernia. The diagnosis was confirmed by chest X-ray, computerized tomography (CT) and/or upper gastrointestinal series. The hiatal repair was done in all patients either by laparotomy or laparoscopy. During the procedure, 2 patients had Nissen fundoplication and 3 patients had Thal fundoplication. Recurrence of hernia occurred in the 2 patients who had Thal fundoplication.
DISCUSSION AND CONCLUSION: Recurrence of sliding hernias with Thal fundoplication seem more frequent in the series. If the esophagogastric junction is present in the thorax, mediastinal dissection of the esophagus may be required to achieve a good abdominal esophagus structure, which will prevent a recurrence.

Konjenital hiatus hernisi- Vaka serisi

GÝRÝÞ ve AMAÇ: Eriþkinlerde sýk olmasýna raðmen, hiatus hernisi çocuklarda nadirdir; konjenital hiatus hernisi ise daha da nadirdir. Bu makalede konjenital hiatus hernisi serimiz yönetim problemleriyle birlikte tartýþýlmýþtýr.
YÖNTEM ve GEREÇLER: Kliniðimizde 2010-2016 yýllarý arasýnda konjenital hiatus hernisi tanýsý konulan hastalar retrospektif olarak deðerlendirildi. Hastalarýn demografik bilgileri, baþvuru semptomlarý, taný yöntemleri, operasyon detaylarý, postoperatif takipleri, erken ve geç dönem komplikasyonlarý incelendi.
BULGULAR: 6 yýllýk sürede konjenital hiatus hernisi tanýsý alan 7 hastanýn 4’ü erkek, 3’ü kýz idi. Bir hasta prenatal tanýlý olup diðeri ortalama 18,6 aylýkken taný aldýlar. Dört hastada tip IV, 2 hastada tip III, 1 hastada tip I hiatus hernisi mevcut idi. Taný akciðer grafisi, bilgisayarlý tomografi veya üst gastrointestinal pasaj serileriyle konuldu. Ýkisi laparoskopik olmak üzere tüm hastalara hiatus onarýmý yapýldý. Hiatus onarýmý sýrasýnda 2 hastaya Nissen fundoplikasyonu, 3 hastaya Thal fundoplikasyonu yapýldý. Thal fundoplikasyonu yapýlan 2 hastada nüks meydana geldi.
TARTIÞMA ve SONUÇ: Serimizde sliding hernisi olup Thal fundoplikasyonu yapýlan hastalarda nüks daha sýk görülmüþtür. Özofagogastrik bileþkenin toraks içerisinde yer aldýðý olgularda özofagusun mediastinal diseksiyonu ile abdominal özofagusun uzatýlmasý rekürrensleri azaltabilir.