- Herniation of the stomach into the thorax
- Sliding: gastro-oesophageal junction above diaphragm
- Rolling: fundus herniates beside the oesophagus
- Disrupts lower oesophageal sphincter leading to gastro-oesophageal reflux
Clinical features
- Usually none
- Heartburn due to reflux
Management
- Treat reflux
- Surgery for large hernias/severe reflux
- Fundoplication
- 360 degrees Nissen
- 270 degrees Toupet
- 180 degrees Dors (done with Heller's myotomy)
No comments:
Post a Comment