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Hiatus hernia: a complication of postero-lateral diaphragmatic herniation (Bochdalek hernia) in infants
Insights
Postero-lateral diaphragmatic (Bochdalek) hernia repair in infants can lead to severe vomiting and large hiatus hernias in survivors. This previously unreported complication requires consideration in post-operative patient assessment.
Area of Science:
- Pediatric Surgery
- Congenital Abnormalities
Background:
- Postero-lateral diaphragmatic hernias, also known as Bochdalek hernias, are a serious congenital condition in infants.
- Surgical repair is the standard treatment for Bochdalek hernias.
Purpose of the Study:
- To report on the outcomes of infants treated for Bochdalek hernias.
- To identify and highlight previously unreported complications following surgical repair.
Main Methods:
- A retrospective review of 23 infants treated for postero-lateral diaphragmatic hernias between January 1973 and February 1979.
- Surgical repair was performed in all cases.
- Follow-up included assessment for complications such as vomiting and diagnostic barium meals.
Main Results:
- Ten out of 23 infants (43%) died post-operatively.
- Severe vomiting occurred in 7 of the 13 survivors (54%).
- Large hiatus hernias were identified in 4 of the 13 survivors (31%) via barium meal examination.
Conclusions:
- Severe vomiting and large hiatus hernias are significant, previously unreported complications following Bochdalek hernia repair in infants.
- Clinicians should consider these potential complications in the post-operative management of infants undergoing Bochdalek hernia repair, especially if vomiting is present.
Abstract:
During the six years from January 1973 to Februrary 1979, 23 infants with postero-lateral diaphragmatic (Bochdalek) hernias have been treated in the Paediatric Surgical Unit of the General Infirmary at Leeds. Surgical repair was performed in all cases. Ten patients died. Severe vomiting occurred in seven (54%) of the 13 survivors. Barium meal demonstrated large hiatus hernias in four (31%) of the 13 survivors. This previously unreported complication of Bochdalek hernia repair should be consideredin all patients with vomiting following surgical repair of a Bochdalek hernia.