Congenital hiatus hernia-A case series

Abstract

OBJECTIVE: Although hiatus hernia frequently occurs in adults, it is rare in children; congenital hiatus hernia is even rarer. We describe a series of infants with congenital hiatus hernia and discuss the management problems. METHODS: Records of patients who were diagnosed with congenital hiatus hernia between 2010 and 2016 were extracted. Demographic data, presentation symptoms, diagnostic investigations, operative details, postoperative follow-up, and early and late postoperative complications were retrospectively evaluated. RESULTS: Among the patients, four were females and three were males. One was prenatally diagnosed, whereas the mean age at the time of diagnosis for others was 18.6 months. Four patients had type IV hiatus hernia, two had type III, and one had type I. The diagnoses were made using chest X-ray, computed tomography, and/or upper gastrointestinal series. The hiatal repair was done in all, in two with laparoscopy. Two patients underwent Nissen fundoplication and three underwent Thal fundoplication during hiatal repair. Recurrence occurred in two patients who had undergone Thal fundoplication. CONCLUSION: Recurrence with sliding hernias and Thal fundoplication seem more frequent in the series. If the esoph-agogastric junction is in the thorax, mediastinal dissection of the esophagus can be considered to have a good abdominal esophagus to prevent recurrence.