Abstract
Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Four types are identified: type Ι or sliding hiatal hernia, type II or paraesophageal hernia (PEH), type III or mixed hernia and type IV. Congenital type II esophageal hiatal hernia is caused by a remaining gap after the formation of pleuroperitoneal membrane. We present a case of a six years old boy admitted to our department, appearing with asymptomatic anemia, who was incidentally diagnosed with Type II esophageal hiatal hernia. After diagnostic investigation, the prolapsing stomach pouch was reduced, the hernia sac was excised, the crura of diaphragm were converged and a total fundoplication was performed, via open method. The patient had an uncomplicated postoperative period. We conclude that: 1) esophageal hiatal hernia should be included within diagnostic approach of a child with chronic non-hereditary anemia, 2) after a Type II esophageal hiatal hernia is diagnosed, a hernia repair surgery is indicated in short time, due to the severity of possible complications and 3) through the performance of total fundoplication, it is secured that the subdiaphragmatic abdominal part of esophagus will be retained, preventing the development of post-operative gastroesophageal reflux disease.
Highlights
Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus
Symptoms of type II hiatal hernias are not caused by gastroesophageal reflux, as the anti-reflux mechanism is not abolished, but, come as a result of acute gastric dilatation – pressing the organs within the chest cavity – or even gastric volvulus
Esophageal hiatal hernia should be included within diagnostic approach of a child with chronic non-hereditary anemia
Summary
Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Type II hiatal hernias are divided into congenital and acquired. Congenital type II hiatal hernia is caused by a remaining gap after the fusion of pleuroperitoneal folds and the formation of pleuroperitoneal membrane. During intrauterine life, this gap has a diameter less than 1 cm. Congenital hiatal hernias are more common in girls (Female/Male ratio = 4) [6]. Baglaj SM et al refer to 21 cases of type II hiatal hernias with familial predisposition, 6 of which were cases of twins [7]
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