A hernia is any abnormal hole in the body allowing body parts from one part of the body to protrude into another. On rare occasions, the stomach can bulge through the diaphragm and end up next to the esophagus. This situation could potentially “strangulate” or cut off the blood supply to the stomach. Called a paraesophageal hernia, this uncommon condition is often related to conditions that lead to increased abdominal pressure such as chronic cough, severe constipation and obesity. Age over 50, excessive body weight and smoking are common risk factors for the disorder.
Symptoms and Diagnosis of Paraesophageal Hernia
Signs of paraesophageal hernia include:
- gastroesophageal reflux (heart burn, bloating, burping)
- chest and/or abdominal pain
- shortness of breath
- nausea and vomiting
Many of the symptoms of paraesophageal hernia mimic those of other GI problems. It is important to obtain an accurate diagnosis from your primary care physician or gastroenterologist. Recommended diagnostic tests may include:
- Chest X-ray
- Upper GI Fluoroscopy Exam (barium swallow esophagram)
- CT Scan
Surgical Treatment Options for Paraesophageal Hernia
For patients with a paraesophageal hernia who are experiencing symptoms (abdominal pain, gastrointestinal bleeding and/or reflux), surgical treatment is typically recommended to prevent a strangulated hernia. Surgical intervention usually involves pushing the stomach or other protrusions back into place. The surgeon then narrows the gap in the diaphragm (hiatus) with sutures and mesh materials to prevent another hernia.
At NorthShore, our experienced thoracic surgeons repair the majority of paraesophageal hernias using minimally invasive laparoscopic surgery. Small incisions are made in the abdomen for the insertion of pencil-thin surgical instruments and a tiny camera. On rare occasion, it may not be possible to fix extremely large hernias laparoscopically. In these cases, an open surgical procedure (thoracotomy) may need to be performed. Thoracotomy involves an incision made on your side, along with gentle rib spreading, to gain access to the area of the hernia repair.
For More Information
To schedule an appointment with one of our thoracic surgeons, please call 847.570.2868.