HIATAL HERNIA

 ABDOMEN AND GROIN AREA.

 FASCIA (COMMON)
 HIATUS (HOLE IN THE MIDDLE OF THE DIAPHRAGM) ALLOWS
ESOPHAGUS AND STOMACH TO COME THROUGH THAT HOLE.
 WHEN STOMACH FINDS BULGING IT WAY THROUGH THE HOLE
(HIATAL HERNIA) THROUGH DIAPHRAGM TO THE STOMACH
 SLIDING HERNIA- SLIDE IN AND OUT TO THE THORAX
 PARAESOPHAGEAL HERNIA (PUSHES ITS WAY AROUND OTHER TUBE
(ESOPHAGUS) CAUSES INCARCINATION OF THE STOMACH.
NO SYMPTOMS (MINIMAL SYMPTOMS) OCCASIONAL HEARTBURN,
INCREASE BURPING, FILLED UP EASILY, CHEST PAIN (METALLIC OR ACID
TASTE) TROUBLE SWALLOWING (DYSPHAGIA) PAIN SWALLOWING
(ODYNOPHAGIA) CHRONIC OR UNEXPLAINED COUGH, ASPIRATE WHEN
LAID UP AT NIGHT
DIAGNOSTIC TEST
 -X-RAY (CAN SEE THE HERNIA).
 -SWALLOW RADIODENSE MATERIAL INTO THE STOMACH (BARIUM
SWALLOW)
 ESOPHAGEAL MANOMETRY
 ESOPHAGOGASTRODUODENOSCOPY (MOUTH-ESO-SMALL
INTESTINES
 -ULTRASOUND
 -CT SCAN
 -MRI
 -ENDOSCOPY ( IF YOU FIND GASTRIC MUCOSA BEFORE DIAPHRAGM
THEN ITS POSITIVE)
HOW TREATED?

 ANTACIDS
 H2 BLOCKER
 PROTON PUMP
 DECREASE FOOD THAT CAUSES STOMACH BLOAT
 SMALL FEEDING FROM LIQUID TO SOLID
 RECLINE 1 HR AFTER EATING (PREVENT ACID REFLUX)
 ELEVATE HEAD OF BED FROM 4-8 INCHES PREVENT HERNIA FROM
SLIDING UPWARD.
 SEMI FOWLER (AVOID ACIDITY)
 Low fat high protein diet
  INCREASE FOOD THAT DECREASE THE ABILITY OF THE BODY TO
REGULATE ACIDS.
SURGERY IF SYMPTOMS ARE BAD
 NISSEN FUNDOPLICATION
 RINGS ARE LESS INVASIVE
COMPLICATIONS
 *CHRONIC ESOPHAGITIS DAMAGE TO LOWER ESOPHAGUS LEADS TO
BARRETT ESOPHAGUS LEADS TO PRE CANCER.

*MONITOR PATIENT FOR VOMITING GAGGING BELCHING ABDOMINAL

DISTENTION AND EPIGASTRIC CHRST PAIN. (POSTOPERATIVE).
REVISISON OF SURGICAL PROCEDURE

FOR NCP:
ACID COMES TO THE MOUTH (PAINFUL) AND VOMITS
-END OF THE ROPE
HIATAL HERNIA
ACID CAUSING IRRITATION THAT CAUSES BARRETT’S METAPLASIA
RISK FOR CANCER
SURGERY IS DECIDED TO RELIEVE THE SYMPTOMS