Effects of large hiatal hernias on esophageal peristalsis.
نویسندگان
چکیده
HYPOTHESIS Anatomic changes induced by large hiatal hernia may alter esophageal pressure topography measurements made during high-resolution manometry. DESIGN Retrospective study. SETTING Single-institution tertiary hospital. PATIENTS Ninety patients with large (>5 cm) hiatal hernias on endoscopy were compared with a control group of 46 patients without hernia selected from the same database of 2000 consecutive clinical high-resolution manometry studies. INTERVENTION High-resolution manometry with at least 7 evaluable swallows for analysis. MAIN OUTCOMES MEASURES Esophageal pressure topography was analyzed for lower esophageal sphincter pressure, distal contractile integral, contraction amplitude, contractile front velocity, and distal latency time. Esophageal length was measured on esophageal pressure topography from the distal border of the upper esophageal sphincter to the proximal border of the lower esophageal sphincter. Esophageal pressure topography diagnosis was based on the Chicago Classification. RESULTS The manometry catheter was coiled in the hernia and did not traverse the diaphragm in 44 patients (49%) with large hernia. Patients with large hernias had lower average lower esophageal sphincter pressures, a lower distal contractile integral, slower contractile front velocity, and shorter distal latency time than patients without hernia. They also exhibited a shorter mean esophageal length. However, the distribution of peristaltic abnormalities was not different in patients with and without large hernia. CONCLUSIONS Patients with large hernias had an alteration of esophageal pressure topography measurements and a shortened esophagus. However, the distribution of peristaltic disorders was unaffected by the presence of hernia.
منابع مشابه
Laparoscopic Paraesophageal Hernia Repair
BACKGROUND AND OBJECTIVE Paraesophageal hernias are uncommon yet potentially lethal conditions. Their repair has now been facilitated by laparoscopic technology. We present a series of 20 patients with paraesophageal hernias repaired laparoscopically. METHODS Twenty patients with paraesophageal hernias had laparoscopic repairs. Eighteen patients had primary repair of their hiatal defect. Two ...
متن کاملHiatal Hernia Complicated by Benign Esophageal Stricture in a Developmentally Delayed Male
Benign esophageal strictures can be defined as a lumennarrowing lesion of the esophagus with no associated malignancy. Severe reflux is the most common asosiated etiology of stricture formation in adults. Hiatal hernias can cause severe reflux and have been identified as a cause of esophageal strictures in adults [1]. Sliding hiatal hernias are characterized by the weakening of diaphragmatic cr...
متن کاملClinical Significance of Hiatal Hernia
The relationship between hiatal hernias and gastroesophageal reflux disease (GERD) has been greatly debated over the past decades, with the importance of hiatal hernias first being overemphasized and then later being nearly neglected. It is now understood that both the anatomical (hiatal hernia) and the physiological (lower esophageal sphincter) features of the gastroesophageal junction play im...
متن کاملReview of Literatures on Laparoscopic Prosthetic Repair of Giant Hiatal Hernia than Pure Anatomical Repair of Crura
The esophagus passes through an opening in the diaphragm (i.e. esophageal hiatus) as it courses through the chest to the abdomen eventually ending at the stomach. This opening is usually adequate for passage of the esophagus and nothing else (Fig. 1). However, patients that have a hiatal hernia have an enlarged opening. There are four different types of hiatal hernias described. Giant hiatal he...
متن کاملHiatal hernias in children: special reference to the short esophagus.
Esophageal hiatal hernias are relatively uncommon in children. Since 1950 we have seen 20 children with hiatal hernias at the Mayo Clinic. During the same period the diagnosis of esophageal hiatal hernia has been made in more than 17,000 adults, and the overwhelming majority of these adults were in the older age group. In this communication we shall review the cases and the roentgenographic fin...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Archives of surgery
دوره 147 4 شماره
صفحات -
تاریخ انتشار 2012