Paraesophageal Hernia: A Life-Threatening Disease

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Abstract

Thirty-one patients with paraesophageal hernia were studied, and their treacherous clinical course and complications are emphasized. Ten patients had acute upper gastrointestinal bleeding, 9 had obstruction, and 2 had perforation. Primary repair was done for 28 patients. Two esophagogastric resections were undertaken for irreversible ischemia and perforation. One patient had closure of the perforation and hernia repair. There were 2 operative deaths, both of which were related to complications of this disease (obstruction, perforation, and mediastinitis). Paraesophageal hernia must be repaired promptly to alleviate symptoms and to prevent serious complications.

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    Citation Excerpt :

    This clinical triad is known as the Borchardt triad, after the individual who first described it in 1904 [15,16]. This constellation of symptoms and findings should lead to an urgent surgical consultation, because a clinical transition from incarceration to gastric strangulation is possible [17–20]. Prompt surgical exploration, and surgical reduction of the incarcerated stomach and repair of the paraesophageal hernia process are generally recommended in this circumstance.

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We wish to acknowledge the help and encouragement of Dr. Watts R. Webb in the preparation of this paper.

Presented at the Ninth Annual Meeting of The Society of Thoracic Surgeons, Houston, Tex., Jan. 22–24, 1973.

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