J.Jpn. Surg. Soc.. 79(9): 1194-1199, 1978
Report on the annual meeting
ESOPHAGEAL HIATAL HERNIA IN INFANCY AND CHILDHOOD
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Department of Surgery I., Gunma University School of Medicine Shiro Matsuyama, et al. |
Of the 32 cases, 27 were diagnosed as sliding type and remaining 5 cases as composite type from the radiological findings. There were no paraesophageal type, nor was a case thought to be the true congenital short esophagus. Age and sex distributions as well as clinical features showed some differences among these two types. Clinically, persistent vomiting starting shortly after birth was a predominant symptome of the sliding type, but protracted vomiting and/or malnutrition were not seen in patients with composite type except in a case with incarceration. Conservative treatment was effective in 13 of the 20 sliding herni as. Prognosis and results of surgery were also different between two types of hernia. Esophageal stricture due to reflux esophagitis was seen in three patients with sliding hernia but never found even in older chil drenwith composite hernia. Ten cases of sliding type and all of composite type of hernia were surgi cally treated and recurrences were seen in 4 of the sliding type within two months after the surgery butthere were no recurrences in composite type of hernia.
All composite and paraesophageal type of hernia indicate surgical treatment, however, heavy antireflux procedure is not necessary. On the other hand, the sliding type of hernia in newborn and young infant is treated conservatively for two weeks and if the baby does not respond to the medical regime, the fundoplication is performed.
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