Lengthening gastroplasty for managing giant paraesophageal hernia

Abstract

The herniation of stomach into the thorax has been classified into four major types. The sliding hiatus hernia (type I), which is the commonest type and accounts for 95% of all cases, has the gastroesophageal (GE) junction as the leading point of the hernia. The GE junction is herniated into the thorax in this type of hernia. The pure paraesophageal hernia (type II), which is extremely rare, is characterized by a GE junction that maintains its intra-abdominal position while the fundus herniates into the chest through the anterolateral hiatus. The majority of the paraesophageal hernias (type III) are a combination of the above two types, in which the GE junction is herniated along with the fundus into the thorax. Finally, type IV hernias are those in which other organs like colon, small intestine, and spleen are also present in the sac. © 2007 Springer-Verlag London Limited.