What is a Paraesophageal hernia?

What do you know about paraesophageal hernia and ways to treat and repair paraesophageal hernia?

What do you know about hiatal hernia and ways to repair hiatal hernia?

What are the signs and symptoms of paraesophageal hernia?


If you want to know more about paraesophageal hernias, which are a type of hiatal hernia, and if you want to know more about ways to repair these hernias, we recommend that you read on.


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If you want to better understand the ways to repair paraesophageal hernias

We have to give a precise definition of hernia in medicine from the beginning. It is said that when a part of the organs in the body is moved to an area to which it does not belong, the so-called hernia has occurred.

Therefore, in order to reach the ways of repair and correction and parapharyngeal and to have a correct understanding of it, it is necessary to learn more about hiatal hernias, of which paraesophageal hernia is one of the types.



The diaphragm is actually a thick muscle that separates the space between the chest and the abdomen.

There is a slit in this diaphragm muscle wall that normally connects the esophagus to the stomach through this slit called the hiatus. When a hernia occurs, a part of your stomach enters the space of the chest through this gap (hiatus).


Types of hiatal hernias

There are generally two main types of hiatal joint:

  1. Rowing hiatal hernia or sliding hiatal hernia
  2. Hiatal esophageal hernia which is located close to the esophagus and adjacent to the esophagus.

In a sliding hiatal hernia, the stomach and part of the esophagus that attach to your stomach and are normally inserted into the abdomen are moved. It is said that this part seems to have slipped up into the chest. In fact, the most common type of hiatal hernia is this type of rolling.


Paraesophageal hernias are less common than Rowling’s hernias, but we need to be more concerned and serious about people who have them, that is, treat the paraesophageal hernia more seriously.


What is a paraesophageal hernia?

This hernia is less common than Rowling’s hernia. In this type of hernia, the esophagus and stomach are in their natural position, but part of the stomach moves with pressure through the hiatus cleft to near the esophagus. If this hernia is present, it may be asymptomatic, but the main danger is that the stomach can become abruptly interrupted and cut off from blood flow, in other words, blood flow is disrupted and gastric tissue death occurs.


What are the symptoms of hiatal hernia?

It is said that according to statistics, many people who have it do not have clinical manifestations and symptoms. On the other hand, some of them may experience symptoms such as the following.


  1. Heartburn, which can be linked to gastro-oesophageal reflux disease, it was once thought that gastro-oesophageal reflux disease may actually be the cause of a person prone to hiatal hernias but this was rejected because it was observed that people without gastro-oesophageal reflux disease also have hiatal hernias and it was suggested that gastric acid reflux into the esophagus is probably one of the complications of hiatal hernia and not its cause.

One of the valuable points to note in this regard is that people with heartburn have gastro-oesophageal reflux disease; they may experience chest pain. This pain can easily be mistaken for angina pectoris. In these people, it is very important for chest pain to accurately diagnose the presence of gastric reflux to the esophagus and to reach the hiatal hernia.

So it is easy to say that perhaps the first symptom and even the only symptom of a person with hiatal paraesoephageal hernias is chest pain, which is mistaken for cardiac angina and during medical examinations and with accurate and specialized diagnostic aids to find the existing hiatal hernia.


What causes paraesophageal hernias?

Doctors say that in most cases it is not possible to determine the exact cause. A person with a large hiatus cleft may have been born congenitally.

Or it may have an increase in intra-abdominal pressure, for example, it may be obese due to a heavy, prolonged and chronic cough, or it may have chronic constipation that he has to push during defecation, or a woman who is pregnant has increased intra-abdominal pressure due to pregnancy.


What are the risk factors for paraesophageal hiatal hernia?

Hiatal hernias occur more often in women than men or in overweight people more than people who are fit and balanced weight. Also, the incidence of hiatal hernias increases with age and people over the age of 50 are more likely to have this hernia than other age groups.


How is a paraesophageal hernia diagnosed?

When a person presents with symptoms of gastroesophageal reflux disease, such as chest pain, the medical team is required to keep in mind gastrointestinal disorders, including gastroesophageal reflux disease, and to gradually look for the cause of the person’s symptoms and manifestations. Use specialized radiology techniques, such as swallowing barium. This method allows the doctor to examine the passage of material from the mouth to the stomach.

In addition to the radiological procedure, the doctor may have noticed a hiatal hernia through endoscopy of the esophagus and stomach.



In this section, we want to say how to repair a hiatal hernia?

Hernia repair means that dislocated limbs that have entered an abnormal area can be returned to their original position.

You have read in previous sections that the prevalence of hiatal hernias of the paraesophageal type is lower than that of Rowling hernia and occurs in rare cases but is much more serious than Rowling hernia.


What is the reason for this greater importance?

In a paraesophageal hernia, because the bulkier and larger part of the stomach is adjacent to the border, it may be pressurized by the edges of the hiatus, thus, the blood supply to this living tissue of the stomach is interrupted and disturbed due to this pressure, in other words, a strangled hernia occurs, and thus causes the death of the part of the gastric tissue that is stuck in the hernia.


In what cases is surgery required?

If the paraesophageal hernia is prone to suffocation, it means that too much pressure is applied to the stomach at the edges of the hiatus, which may cut off blood flow to the living stomach tissue and the living tissue dies.

If there is a risk, surgery must be performed, which means that when it is said that hernia repair surgery means surgery in which the organs removed from their normal space are returned to their original place, That is, the stomach moves from the chest space to its place, the abdominal space.

There are different ways and methods for this surgery. Surgery may be performed laparoscopy. Laparoscopic surgery is a major revolution in surgery. Laparoscopies are less invasive surgical methods and are better tolerated by patients, Injuries are less and recovery is faster and better results are seen.

In laparoscopic surgery, small incisions 5 to 10 mm long are made in the abdominal wall at the required location, and the necessary surgical tubes and instruments are inserted through the incision. These laparoscopic tubes are equipped with light as well as a camera, which makes it possible that allows the doctor and the surgical team to observe the space inside the body on the TV in front of them and then decide from their observations what treatment measures are needed. Surgical instruments and equipment can also enter the space inside the body with the above tubes from small incisions and operate on the person.

The advantages of laparoscopic surgery over laparotomy, which is equivalent to open surgery and open the abdomen, are Sometimes used in hiatal hernias, especially paraesophageal hernias, it requires the thorax or chest to open at the same time as the abdomen, and this opening of the two major body spaces carries a great deal of risk to the patient, often to people with hiatal hernias or elderly and have underlying diseases such as cardiovascular problems and they can’t tolerate prolonged anesthesia or long incisions from the chest to the lower abdomen, The risk of infection increases with these surgeries. There are also complications of long-term anesthesia, and the risk of cardiorespiratory problems is higher in these people.

Today, with the advances in laparoscopic surgery, it has become possible for these patients to get rid of paraesophageal hiatal hernia without any life-threatening complications during laparotomy with thoracotomy.


Benefits of Laparoscopic Surgery

The gap is smaller so the risk of infection will be less. The patient’s pain during recovery is less. The size of the wound is less.

And postoperative recovery will be faster and with fewer complications. When surgery is performed Laparoscopy to repair a paraesophageal hernia, after surgery, the patient will be able to be discharged from the hospital the day after surgery with a doctor’s approval. A person can eat without any restrictions in the diet and can start their daily activities according to their circumstances. It is said that when a patient undergoes paraesophageal hernia repair surgery, it takes three months to complete a recovery. Considerations of the intensity of activity can be taken into consideration. It is best to avoid heavy lifting for three months after surgery. An important point that statistics show is that there is no way to guarantee that even with the presence of paraesophageal hernia repair surgery, recurrence of the hernia will not occur later.


When should I see a doctor?

If a person has been diagnosed with hiatal hernia and is now experiencing severe pain, such as chest or abdominal pain, or if the person has severe, recurrent, chronic nausea, or chronic or prolonged constipation, or may not even be able to Stomach and bowel movements are more likely to have a suffocating hernia or obstruction in the upper gastrointestinal tract. Both cases of obstruction are medical emergencies and should be referred to the emergency department as soon as possible. Delaying a visit to the emergency room doctor can cost the patient his life.


What are some ways to prevent a paraesophageal hernia?