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ACQUIRED PARAESOPHAGEAL AND DISPARAESOPHAGEAL HERNIAS

COMPLICATIONS OF HIATAL HERNIA REPAIR

TERRY HOYT M.D. and MYO M. KYAW M.D.

Modern methods of hiatal hernia repair require fixation of the gastroesophageal junction below the diaphragm, as well as repair of the hernia defect.

Postsurgical herniations through the diaphragm may occur. With the gastroesophageal junction fixed in place, the new herniations will be either beside the esophagus (paraesophageal) or separated from it by intervening diaphragm (disparaesophageal). Irregularities of the diaphragm may be created by sutural attachments.

Any of these may simulate diaphragmatic tumor or traumatic rupture of the diaphragm. Either type of hernia may be symptomatic.

The mechanism of hernia formation in 3 such cases is described, and methods of diagnosis are discussed.


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