Cougard P, Sala J J, Favre J P, Viard H
J Chir (Paris). 1985 Jun-Jul;122(6-7):399-402.
Of 450 patients treated for hiatus hernia, a review of case-reports showed ulcers of the neck in 15 patients (3,1%). Frequency of hemorrhage was high (13/15), and it was sometimes severe, one patient dying from massive bleeding preoperatively. Diagnosis was by radiology in 11 cases, by endoscopy in 3 and perioperatively in one case. Data on physiopathogenicity include both mechanical and chemical factors. Conservative treatment with repair of hiatus hernia combined or not with vagotomy was performed in 11 patients. Severity of hemorrhagic phenomena or absence of preoperative biopsy led to direct surgery on ulcer in 3 cases, while evidence of mediastinal inflammatory processes required major surgery in 1 patient and an upper pole esophagogastrectomy in another. Long-term follow up failed to show evidence of recurrence of ulcer or hemorrhage.
在450例接受裂孔疝治疗的患者中，对病例报告的回顾显示15例患者（3.1%）出现颈部溃疡。出血发生率很高（13/15），有时很严重，1例患者术前死于大出血。11例通过放射学诊断，3例通过内镜检查诊断，1例在围手术期诊断。关于发病机制的数据包括机械和化学因素。11例患者采用保守治疗，即修复裂孔疝，联合或不联合迷走神经切断术。3例因出血现象严重或术前未进行活检而直接对溃疡进行手术，1例因纵隔炎症过程的证据需要进行大手术，另1例需要进行食管胃上极切除术。长期随访未发现溃疡或出血复发的证据。
