Hiatus hernia by Dr.K.AmrithaAnilkumar
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HIATUS HERNIA DEFINITION It is the most common type of diaphragmatic hernia TYPES Sliding hernia (85%). Rolling hernia (10–12%). Combined SAINT’S TRIAD Hiatus hernia Diverticulosis Gallstones .
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Hiatus hernia by Dr.K.AmrithaAnilkumar
- 1. en love da Homoeopathy HIATUS HERNIA
- 3. HIATUSHERNIA DEFINITION • Itis the most common type ofdiaphragmatic hernia TYPES • Sliding hernia (85%). • Rollinghernia (10–12%). • Combined SAINT’STRIAD • Hiatushernia • Diverticulosis • Gallstones.
- 4. CLASSIFICATION-Typesof hiatushernia TypeIhiatus hernia: • It is the cephalad displacement of the gastro- oesophagealjunction throughthe hiatusintothe mediastinum. • It isusually small, asymptomaticand reducible. • It iscommonest type TypeII hiatushernia: • It issuperior migrationof the fundus of the stomach alongside the GE junction andoesophagusintothe mediastinumwithGE junctioninnormal intra- abdominal location. • It is rolling hernia
- 5. TypeIIIhiatus hernia: • It is combinationof typeI and type II TypeIV hiatushernia: • It is the hernia containing other abdominalvisceraas contentliketransversecolon and omentum
- 6. FEATURES • Sliding hernia is commonly associatedwith GORD (should be discussed like GORD).Here the cardia migratesback and forth between the posterior mediastinum and peritoneal cavity.
- 7. Gradingof hiatus hernia GradeTypeI • H0 Normal II • H1 Sliding III • H2Rolling IV • H3 Mixed V • H4 Massive herniation ROLLINGHERNIA (PARAOESOPHAGEAL HERNIA) • Itis herniation of stomach fundusor rarelyother abdominalcontents colon/spleen througha hiatus, usually towards leftside.
- 8. CLINICALFEATURES • Commoninelderly. • Abdominalpainand chest pain. • Hiccough, early satiety. • Regurgitation, postprandialbloating. • Cardiacabnormality (arrhythmia). • Dysphagia dyspnoea. • 40% presentsas acute features with perforation/gangrene/ bleeding
- 9. INVESTIGATION • PlainX-ray—lateraland PAerectviewshowing retrocardiac airfluidlevel. • Bariummeal study very useful. • ECG. • 3DCTscan is useful. TREATMENT • Treatmentis always surgical. • Excisionofsac andrepair of the defect. • If itis gangrenous, gastrectomyisrequired. • Eitherabdominalor thoracicor laparoscopic approach can be usedin treating rolling hernia surgically COMPLICATION • Gangreneof stomach. • Perforationinto the mediastinum. • Perforationinto the peritoneum.
- 10. • Gastricvolvulus. • Ischaemic • longitudinalulcerinthe herniatedstomachin rolling hernia is calledas Cameron ulcer. REFERENCE 1. SRB's Manual of Surgery by SriramBhat M 2. A Manual on Clinical Surgeryby Das 3. A Concise textbookof Surgeryby Das
- 11. A Special Thanks To A Very Special Doctor