Clinical characteristics of neonatal mesenteric hiatal hernia

Neonatal mesenteric hiatal hernia (MHH) is a rare but serious congenital abnormality. Due to the lack of specific clinical features, it poses challenges for diagnosis and treatment. Early identification and timely intervention are crucial for improving neonatal outcomes. This study aims to explore the clinical characteristics, diagnostic methods, and treatment outcomes of neonatal MHH.

A retrospective analysis was conducted on seven cases of neonatal MHH admitted to the First Department of General Surgery at Hebei Children's Hospital from January 1, 2010, to September 30, 2024. General information, clinical data, examination results, and surgical conditions of the patients were collected and analyzed.

The average hospital stay for the seven neonatal MHH patients was 16.57 days. No complications such as bowel obstruction were observed during the 12 to 24 months of postoperative follow-up. The clinical symptoms were primarily abdominal distension, with some patients also presenting with vomiting, abdominal pain, and other symptoms. The imaging examinations showed that most patients exhibited signs of bowel obstruction and some CT scans revealed features such as bowel loop aggregation and mesenteric vascular abnormalities. Laboratory tests indicated mild inflammation and slight functional abnormalities in some organs. Regarding surgery, five patients underwent conversion to open surgery. The hernia defects were mainly located at the terminal ileum and ileocecal junction. Six patients required bowel resection due to bowel necrosis and four of them underwent ostomy procedures. All patients recovered well postoperatively.

Neonatal MHH is a rare and complex condition, with imaging playing a key role in early diagnosis. Laparoscopic surgery is the preferred treatment method due to its minimal invasiveness and quick recovery. Future efforts should focus on enhancing clinical awareness of this condition and integrating clinical symptoms with relevant examinations to improve early diagnosis and treatment outcomes.