Related Experiment Video
Updated: Jul 20, 2026
10:52
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Primary paraesophageal hernia in children
Jonathan S Karpelowsky1, Nicky Wieselthaler, Heinz Rode
1Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
Journal of Pediatric Surgery
|September 6, 2006
Summary
Paraesophageal hernias in children are rare congenital defects causing significant morbidity. Surgical repair principles are established, emphasizing antireflux procedures for optimal outcomes.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Abnormalities
Background:
- Paraesophageal hernias (PEH) in children are distinct from sliding hiatus hernias.
- They present unique anatomical, pathological, and clinical challenges in pediatric patients.
Purpose of the Study:
- To review a single institution's experience with pediatric paraesophageal hernias.
- To analyze the pathology, presentation, management, and outcomes of PEH in children.
Main Methods:
- Retrospective analysis of patient records.
- Review of 59 children treated for paraesophageal hernias over 42 years.
Main Results:
- Common presentations included recurrent chest infections, vomiting, anemia, and failure to thrive.
- Surgical repair involved sac excision, crural approximation, and fundoplication in most cases.
- Postoperative complications included bowel obstruction and intussusception; mortality was linked to preoperative aspiration.
Conclusions:
- Pediatric PEH are uncommon, likely congenital, and associated with significant morbidity.
- Strangulation is not a typical feature.
- Established surgical repair principles include an antireflux procedure.
Related Concept Videos
01:25Hiatal Hernia
A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
01:30Esophageal Strictures-I: Introduction
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:27Esophageal Achalasia
Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
01:21Barrett Esophagus-I: Introduction
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...