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Two Cases of Congenital Paraesophageal Hiatal Hernia in Infancy

Journal of the Korean Pediatric Society 2000;43(12):1613-1620.
Published online December 15, 2000.
Two Cases of Congenital Paraesophageal Hiatal Hernia in Infancy
Ji Yeon Hong1, Kih Yeon Song1, Woo Ki Lee1, Kwang Woo Kim1, Jong Gon Ha2, Soon Ok Choi3
1Department of Pediatrics, Sunlin Hospital, Handong University, Pohang, Korea
2Department of Chest Surgery, Sunlin Hospital, Handong University, Pohang Korea
3Department of Pediatric Surgery, Keimung University School of Medicine, Taegu, Korea
영아에서 발견된 선천성 식도주위 열공 탈장 2례
홍지연1, 송기연1, 이우기1, 김광우1, 하종곤2, 최순옥3
1한동대학교 선린병원 소아과
2한동대학교 선린병원 흉부외과
3계명대학교 의과대학 동산의료원 소아외과
Abstract
Herniation of the stomach through the esophageal hiatus into the posterior mediastinum is a commom affliction of humans. The incidence of hiatal hernia is difficult to determine because of the absence of symptoms in a large number of patients. Hiatal hernias are classified into two major types; type I sliding hiatal hernia and type II paraesophageal hiatal hernia. Sliding hernia is common, but paraesophageal hernia(PEH) is rare. Most PEH is demonstrated in elderly women. PEH in infancy is really rare. PEH is a true hernia, so it is a potentially life-threatening condition because of the risk of volvulus, incarceration, strangulation, and perforation. PEH is itself the indication for surgery. We experienced congenital PEH in two infants. One case was nearly asymptomatic, found incidentally by plain chest X-ray taken for pneumonia in a 12 month old female infant. She had no vomiting or reflux, but history of frequent feeding of small amount and often gurgling noise in her right chest. She had type IV PEH including herniation of the transverse colon. Another case was presented because of vomiting, and was diagnosed by ultrasonography initially in a 48 day old male infant. He had intrathoracic stomach, type III PEH with idiopathic hypertrophic pyloric stenosis and gastroesophageal reflux.
Key Words: Paraesophageal hiatal hernia, Congenital, Idiopathic hypertrophic pyloric stenosis, Gastroesophageal reflux


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