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Hiatal hernias

Shingo Takashima, Fumio Tanaka, Koji Otani, Shuhei Hosomi, Yasuaki Nagami, Noriko Kamata, Koichi Taira, Hirokazu Yamagami, Tetsuya Tanigawa, Shinya Fukumoto, Toshio Watanabe, Yasuhiro Fujiwara
BACKGROUND: Although both eosinophilic esophagitis (EoE) and Barrett's esophagus (BE) are considered to be associated with T helper (Th) 2-mediated immune responses, the association between EoE and BE is unclear. We investigated the clinical relationship between EoE and BE. METHODS: We conducted a single-center retrospective observational study. The study included 95 patients with EoE and randomly selected age- and sex-matched controls who underwent esophagogastroduodenoscopy during a medical health check-up at Osaka City University in a ratio of 1:2 for comparison...
October 16, 2018: Esophagus: Official Journal of the Japan Esophageal Society
M Shalaby, P Polisca, G Missori, P Sileri
Unfortunately, the 2nd affiliation of Shalaby has been missed out in the original publication.
October 15, 2018: Techniques in Coloproctology
Yuki Ushimaru, Kiyokazu Nakajima, Tsuyoshi Takahashi, Makoto Yamasaki, Masaki Mori, Yuichiro Doki
BACKGROUND: Achalasia patients occasionally coexist with esophageal hiatal hernias. The purpose of this study was to clarify the incidence and clinical features of achalasia cases concomitant with hiatal hernia, and to investigate whether our surgical technique was appropriate. METHODS: Consecutive achalasia patients who underwent laparoscopic Heller myotomy with Dor fundoplication (LHD) were extracted from the prospectively compiled surgical database, and the perioperative outcomes and the presence rate of hiatal hernia were obtained...
October 10, 2018: Digestive Surgery
Bassem Abou Hussein, Ali Khammas, Mariam Shokr, Maiyasa Majid, Mariam Sandal, Sameer Al Awadhi, Alya Al Mazrouei, Faisal Badri
Introduction  The routine use of preoperative endoscopy for patients undergoing bariatric surgery is controversial. Although many surgeons find it unnecessary, others still consider it a mandatory tool in preoperative assessment. Patients and methods  We reviewed the medical records of all patients who had undergone preoperative endoscopy before bariatric surgery in Rashid Hospital between January 2013 and June 2016. The patients were divided into three groups: Group 0 included patients with normal endoscopy; Group 1 included patients with abnormalities that did not affect the timing or type of procedure; Group 2 included patients with abnormalities that had a direct impact on the procedure...
October 2018: Endoscopy International Open
Bengt Håkanson, Lars Lundell, Ioannis Rouvelas, Anders Thorell
A hiatal hernia is a partial or total dislocation of the stomach, sometimes together with other intraabdominal organs, through the diaphragmatic esophageal hiatus into the thoracic cavity. The condition is common and often asymptomatic. Old age and obesity are risk factors for developing hiatal hernia. Small hernias might induce gastroesophageal reflux, which usually is satisfactorily treated pharmacologically. Larger hiatal hernias are more often associated with obstructive symptoms including dysphagia, vomiting or discomfort/pain due to compression of adjacent organs/tissues...
October 8, 2018: Läkartidningen
Priscila R Armijo, Dietric Hennings, Melissa Leon, Akshay Pratap, Austin Wheeler, Dmitry Oleynikov
BACKGROUND: Gastroesophageal reflux disease (GERD) and esophageal dysmotility are often disqualifying criteria for fundoplication due to dysphagia complications. A tailored partial fundoplication may improve GERD in patients with severe esophageal motility disorders. We evaluate this approach on GERD improvement in non-achalasia esophageal dysmotility patients. METHODS: A single-institution prospective database was reviewed (2007-2016), with inclusion criteria of GERD, previous diagnosis of non-achalasia esophageal motility disorder, and laparoscopic partial fundoplication...
October 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Silvia Tresoldi, Anna Ravelli, Sara Sbaraini, Claudia Khouri Chalouhi, Francesco Secchi, Gianpaolo Cornalba, Gianpaolo Carrafiello, Francesco Sardanelli
OBJECTIVES: To assess the computed tomography coronary angiography (CTCA) accuracy for demonstrating possible non-cardiovascular causes of non-acute retrosternal chest pain in patients without known coronary artery disease (CAD) and to correlate CTCA results with the patient management and relief from pain. METHODS: This prospective observational study was approved by the ethical committee. Consecutive patients suffering non-acute chest pain who underwent CTCA and with not known CAD were enrolled and classified as having coronary diseases (CD) or extracardiac diseases (ECD)...
October 1, 2018: Insights Into Imaging
Matthew Rochefort, Jon O Wee
The ideal operative solution to giant paraesophageal hernias involves a complex evaluation of the functional anatomy and the intraoperative assessment of both esophageal length and crural closure tension. The addition of surgical adjuncts such as extended transmediastinal dissection, Collis gastroplasty, and mesh reinforcement are all necessary, on an individualized basis, to address these 2 primary causes of hernia recurrence. We discuss the options available.
November 2018: Thoracic Surgery Clinics
Medhat Fanous, Wei Wei, Anja Jaehne, David Lorenson
No abstract text is available yet for this article.
July 1, 2018: American Surgeon
Chin Hong Lim, Phong Ching Lee, Eugene Lim, Jeremy Tan, Weng Hoong Chan, Hong Chang Tan, Sonali Ganguly, Kwang Wei Tham, Alvin Eng
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become the preferred bariatric procedure in many countries. However, there is one shortcoming of LSG in the long-term follow-up and this is the onset of GERD and erosive esophagitis (EE). Current evidence of the effect of SG on GERD did not consolidate to a consensus. In this study, we objectively evaluate the incidence of EE 1 year post-LSG with upper endoscopy (EGD) and try to identify the significant variables and possible underlying mechanisms of the EE post-LSG...
September 21, 2018: Obesity Surgery
Salvatore Tolone, Edoardo Savarino, Giovanni Zaninotto, C Prakash Gyawali, Marzio Frazzoni, Nicola de Bortoli, Leonardo Frazzoni, Gianmattia Del Genio, Giorgia Bodini, Manuele Furnari, Vincenzo Savarino, Ludovico Docimo
Background: Hiatal hernia is diagnosed by barium-swallow esophagogram or esophagogastroduodenoscopy, with possible suboptimal results. High-resolution manometry clearly identifies crural diaphragm and lower esophageal sphincter. Objectives: To assess the diagnostic accuracy of high-resolution manometry in detecting hiatal hernia compared to esophagogram and esophagogastroduodenoscopy, using as reference the surgical in vivo measurement. Methods: Patients were studied with esophagogram, esophagogastroduodenoscopy, high-resolution manometry and in vivo evaluation of the esophago-gastric junction...
August 2018: United European Gastroenterology Journal
Nobuo Omura, Fumiaki Yano, Kazuto Tsuboi, Masato Hoshino, SeRyung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga
BACKGROUND: Surgical results of GERD have mainly been reported from the Western countries, with a few reports found in Japan. We examined the surgical results of laparoscopic Toupet fundoplication and clarify the characteristics of recurrent cases. METHODS: The subjects included 375 patients who underwent laparoscopic Toupet fundoplication from June 1997 to December 2016 as the initial surgery. Patient characteristics, pathophysiology, and surgical results were examined...
October 2018: Esophagus: Official Journal of the Japan Esophageal Society
Matteo Fontana, Roberto Tonelli, Filippo Gozzi, Ivana Castaniere, Alessandro Marchioni, Riccardo Fantini, Francesca Coppi, Filippo Natali, Elisabetta Rovatti, Enrico Clini
Background: Hemoptysis is a frequent sign of respiratory and non-respiratory diseases. While in most cases the underlying cause is rapidly identified, sometimes the real etiology might be misdiagnosed with dramatic delay in treatment. Case presentation: A 46-year-old man with hiatal hernia and a history of aortic surgery for aortic coarctation presented with dramatic episodes of hemoptysis and subsequent severe anemia (6,9 g/dl). Digestive and respiratory endoscopy resulted not exhaustive, thus he underwent a contrast-enhanced computed tomography (CT) scan of the chest that showed an aneurysmal dilatation of the descending thoracic aorta with suspected aortobronchial fistula...
2018: Multidisciplinary Respiratory Medicine
Swathi Eluri, Sara R Selitsky, Irina Perjar, Johnathan Hollyfield, Renee Betancourt, Cara Randall, Spencer Rusin, John T Woosley, Nicholas J Shaheen, Evan S Dellon
BACKGROUND AND AIMS: Few factors have been identified that can be used to predict response of patients with eosinophilic esophagitis (EoE) to topical steroid treatment. We aimed to determine whether baseline clinical, endoscopic, histologic, and molecular features of EoE can be used to predict histologic response. METHODS: We collected data from 97 patients with EoE, from 2009 through 2015, treated with a topical steroid for 8 weeks; 59 patients had a histologic response to treatment...
September 10, 2018: Clinical Gastroenterology and Hepatology
Jimin Han, Matthew Chin, Kyle J Fortinsky, Reem Sharaiha, Christopher J Gostout, Kenneth J Chang
Background and study aims  This preliminary study was conducted to determine the feasibility and safety of endoscopic augmentation of the gastroesophageal junction (GEJ) using the Apollo OverStitch endoscopic suturing system in patients with gastroesophageal reflux disease (GERD) symptoms. Patients and methods  Endoscopic augmentation of GEJ was performed on 10 consecutive patients and the data were analyzed retrospectively. Using a double-channel gastroscope affixed to the endoscopic suturing platform, interrupted sutures were placed on the gastric side of the GEJ in 2 layers in order to create a narrowed and elongated GEJ...
September 2018: Endoscopy International Open
Michael Antiporda, Chloe Jackson, C Daniel Smith, Mathew Thomas, Enrique F Elli, Steven P Bowers
BACKGROUND: Outcomes are not well studied in patients undergoing remediation for multi-fundoplication failure, that is, two or more prior failed fundoplications. Re-operation must balance reflux control and restoration of the ability to eat with the challenge of reconstructing a distorted hiatus and GE junction. The purpose of this study is to present our experience with surgical remediation for multi-fundoplication failure. METHODS: Medical records were retrospectively reviewed of 91 patients who underwent third time or more esophagogastric operation for fundoplication failure at a single institution from 2007 to 2016...
September 12, 2018: Surgical Endoscopy
Dhyanesh A Patel, Rohit Sharda, Yash A Choksi, James C Slaughter, Tina Higginbotham, C Gaelyn Garrett, David O Francis, Karthik Ravi, Stephen Hasak, David Katzka, C Prakash Gyawali, Michael F Vaezi
BACKGROUND AND AIMS: It is not clear whether we should test for reflux in patients with refractory heartburn or extra-esophageal reflux (EER) symptoms, such as cough, hoarseness, or asthma. Guidelines recommend testing patients by pH monitoring when they are on or off acid-suppressive therapies based on pre-test probability of reflux, determined by expert consensus. However, it is not clear what constitutes a low or high pre-test probability of reflux in these patients. We aimed to develop a model that clinicians can use at bedside to estimate pre-test probability of abnormal reflux...
August 28, 2018: Gastroenterology
Yuichi Endo, Masayuki Ohta, Kazuhiro Tada, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Hiroki Uchida, Yukio Iwashita, Masafumi Inomata
PURPOSES: The choice between performing routine and selective upper gastrointestinal endoscopy (UGE) before bariatric surgery remains controversial. This study aimed to evaluate the clinical significance of UGE before laparoscopic bariatric procedures. METHODS: We enrolled 155 obese Japanese patients who underwent laparoscopic bariatric procedures at our institute and evaluated their endoscopic findings, such as reflux esophagitis (RE), hiatal hernia (HH), Barrett's esophagus, gastritis, duodenitis, gastroduodenal ulcer, gastric cancer, and polyps...
August 25, 2018: Surgery Today
Shunsuke Doi, Sohei Matsumoto, Kohei Wakatsuki, Kazuhiro Migita, Masahiro Ito, Tomohiro Kunishige, Hiroshi Nakade, Kinta Hatakeyama, Chiho Ohbayashi, Masayuki Sho
BACKGROUND: An esophageal neuroendocrine carcinoma arising in Barrett's esophagus is extremely rare. Here, we report a case of an esophageal neuroendocrine carcinoma with a well-differentiated adenocarcinoma component arising in Barrett's esophagus and review the literature. CASE PRESENTATION: A 71-year-old man with no symptoms was admitted to our hospital because of the detection of an esophagogastric junction tumor on regular upper endoscopy screening. Endoscopy revealed a sliding hiatal hernia and an approximately 10 mm elevated mass at the esophagogastric junction...
August 29, 2018: Surgical Case Reports
Mi Kyeong Kim, Junoik Shin, Jeong-Hyun Choi, Hee Yong Kang
A hiatal hernia refers to herniation of the abdominal organs through the esophageal hiatus of the diaphragm. A giant hiatal hernia affects digestive and cardiopulmonary function by compressing the organs. We report a patient who had low-dose combined spinal and epidural anesthesia (CSEA) for safe and effective anesthesia for conservative treatment of a giant hiatal hernia. An 84-year-old woman who had a giant hiatal hernia was scheduled for ureteroscopic removal of a ureteral stone. CSEA was performed at the L4 to L5 lumbar interspace and an epidural catheter tip was placed 5 cm cephalad from the inserted level...
October 2018: Journal of International Medical Research
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