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Surgical management of hiatal hernia in children

T C Jewett, D J Waterston

    Journal of Pediatric Surgery
    |October 11, 1975
    PubMed

    Insights

    Early diagnosis of hiatal hernia in children with emesis and failure to thrive is crucial. Nissen fundoplication is superior to gastropexy for preventing reflux recurrence and improving nutritional status.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology

    Background:

    • Hiatal hernia in children can lead to emesis and failure to thrive.
    • Long-standing peptic esophagitis can cause irreversible esophageal damage.

    Purpose of the Study:

    • To emphasize the importance of including hiatal hernia in the differential diagnosis for pediatric patients presenting with emesis and failure to thrive.
    • To evaluate the efficacy of different surgical interventions for hiatal hernia and gastroesophageal reflux.

    Main Methods:

    • Comparative analysis of surgical techniques including Nissen fundoplication, gastropexy, and colon interposition.
    • Review of patient outcomes focusing on reflux recurrence and nutritional improvement.

    Main Results:

    • Nissen fundoplication demonstrated superior outcomes in preventing gastroesophageal reflux recurrence compared to gastropexy.
    • Colon interposition is indicated when hiatal herniorrhaphy is technically unfeasible.
    • Successful hiatal hernia repair led to rapid nutritional status improvement in pediatric patients.

    Conclusions:

    • Early diagnosis and surgical intervention for pediatric hiatal hernia are essential to prevent esophageal damage and improve patient outcomes.
    • Nissen fundoplication is the preferred surgical approach for managing recurrent gastroesophageal reflux in children.
    • Prompt surgical repair significantly enhances the nutritional status of affected children.

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