Link: http://www.ncbi.nlm.nih.gov/pubmed/25783400

J Pediatr Surg. 2015 Jan 17. pii: S0022-3468(15)00050-0. doi: 10.1016/j.jpedsurg.2015.01.007. [Epub ahead of print]
Congenital paraesophageal hernia: The Montreal experience.
Yousef Y1, Lemoine C2, St-Vil D2, Emil S3.
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Abstract
INTRODUCTION:
Congenital paraesophageal hernia (CPEH) is the least common congenital diaphragmatic hernia. We performed an extensive review to further define this entity.

METHODS:
A retrospective study of children with CPEH (types II-IV hiatal hernias) treated at two children's hospitals over a 25-year period (1988-2013) was performed.

RESULTS:
Fourteen patients were diagnosed at a median age of 35days (range 0-500), with one prenatal diagnosis. The most common symptoms were emesis in type II hernias (50%), and respiratory distress in types III and IV hernias (75% and 50%, respectively). Gastroesophageal reflux was concomitantly diagnosed in 50%, while concurrent congenital anomalies existed in 36%. A correct initial diagnosis was made in only 29% of cases. The diagnosis was most often established by UGI study (64%). The method of repair was laparoscopy in 21%, and laparotomy in 71%. An antireflux procedure was done in 13 (93%) patients. Long-term follow up data was available for 86% of patient. During follow-up, one patient recurred and one required sequential pneumatic esophageal dilations. There were no mortalities.

CONCLUSIONS:
CPEH is a rare entity often associated with gastroesophageal reflux disease and other congenital anomalies. Prognosis is excellent, but awareness of this anomaly may lead to earlier diagnosis.

Copyright © 2015 Elsevier Inc. All rights reserved.

KEYWORDS:
Children; Congenital paraesophageal hiatal hernia; Gastroesophageal reflux; Surgery
PMID: 25783400 [PubMed - as supplied by publisher]