Sindjić Sanja, Lukac Marija, Lukac Radoslav, Radlović Nedeljko, Leković Zoran, Jesić Milos, Maglajić Svjetlana, Mandić Maja
Srp Arh Celok Lek. 2004 Oct;132 Suppl 1:45-8. doi: 10.2298/sarh04s1045s.
A small group of three patients presented in our study represents extraordinary and very complicated problem of congenital hiatus hernia in infant period from 6th to 9th month of life, associated with gastroesophageal reflux and consecutive esophageal stenosis. There are two very rare and delicate entities within differential diagnosis, in the domain of the same pathology: congenitally short esophagus and congenital esophageal stenosis; with completely different surgical options for their treatment. That is why an optimal diagnostics and an adequate operative technique are extremely important for the treatment of hiatus hernia. The uppergastrointestinal barium radiography is definitely the method of diagnosing hiatus hernia, which provides typical, almost pathognomonic image of hiatus hernia accompanied by the esophageal stenosis. Nissen fundoplication is the technique of choice for its surgical treatment, with gastrostomy for probable postoperative esophageal dilatation. The results are more than satisfying: early peroral feeding, with spontaneous resolving of esophageal stenosis, which significantly diminishes the need for esophageal bougienage.
在我们的研究中，有一小群三名患者，他们代表了婴儿期（6至9个月大）先天性食管裂孔疝这一特殊且非常复杂的问题，伴有胃食管反流和继发性食管狭窄。在同一病理范畴的鉴别诊断中，存在两种非常罕见且棘手的情况：先天性短食管和先天性食管狭窄；它们的治疗需要完全不同的手术方式。这就是为什么最佳的诊断和适当的手术技术对于食管裂孔疝的治疗极为重要。上消化道钡剂造影绝对是诊断食管裂孔疝的方法，它能提供伴有食管狭窄的食管裂孔疝典型的、几乎具有诊断性的图像。nissen胃底折叠术是其手术治疗的首选技术，并可能进行胃造口术以用于术后食管扩张。结果非常令人满意：早期经口喂养，食管狭窄自行缓解，这显著减少了食管扩张术的需求。
