Question

Hernia

What is a paraesophageal hernia?

A Answers (3)

  • AHealthwise answered

    A hernia is tissue from inside the abdomen that bulges out through a weak spot in the muscles of the abdominal wall. In a paraesophageal hernia, the stomach bulges up through an opening in the diaphragm (hiatus) alongside the esophagus.

    A paraesophageal hernia is not common. But it may occur when the opening in the diaphragm next to the esophagus is abnormally large. The stomach and, in rare cases, other abdominal organs (such as the intestine, spleen, or colon) may also bulge into the chest cavity with a paraesophageal hernia.

    Paraesophageal hernias tend to get worse over time. Surgery is usually needed to treat the problem, especially if the hernia is causing symptoms.

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  • In a hiatal, or hiatus hernia, a portion of the stomach penetrates (herniates) through a weakness or tear in the hiatus of the diaphragm, the small opening that allows the esophagus to pass from the neck and chest to its connection with the stomach.

    A paraesophageal hernia and intrathoracic stomach is a severe type of hiatal hernia in which the fundus, or upper portion of the stomach, may slide upward into the chest cavity through the hiatus. The condition occurs as an intensifying of a sliding hiatal hernia. In rare cases, the entire stomach and even some of intestines may migrate through the hiatus and rest on top of the diaphragm next to the esophagus, a condition known as giant esophageal hernia.

    Symptoms of paraseophageal hernia may include problems swallowing, fainting, and vomiting.

  • AJohn Linn, MD, General Surgery, answered on behalf of NorthShore University HealthSystem

    A paraesophageal hernia is also known as a hiatal hernia, where a portion of the stomach slides through the diaphragm and into the chest. This may cause symptoms of pain, heartburn, reflux, and difficulty swallowing food. Sometimes it causes food or even liquids to become "stuck" as they go down the esophagus.

     

    Surgery is usually recommended for paraesophageal hernias and hiatal hernias of the diaphragm that cause symptoms. Surgery is usually performed laparoscopically and patients are admitted for 1 day after surgery. The surgery involves fixing the hernia and using the stomach to prevent further reflux into the esophagus. The results of surgery tend to be very good, with most patients having significant improvement in their symptoms afterward. Surgery is best performed by experts who have significant experience with these and other esophageal operations.

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