Paraesophageal Hernia

A hernia occurs when an internal body part pushes into an area where it doesn’t belong. There are two main types of hiatal hernias: sliding and paraesophageal. In a sliding hiatal hernia, the stomach and section of the esophagus slide into the chest through an opening (hiatus) in the diaphragm (muscular wall that separates the chest from the abdomen). A paraesophageal hernia is a type of hiatal hernia where part of the stomach is squeezed up into the chest beside the esophagus. A paraesophageal hernia is less common but can become dangerous if it causes the stomach to become strangled, or have its blood supply cut off.

What causes a hernia is not known for sure, however, some doctors think it may be caused by:

  • Coughing
  • Straining during a bowel movement
  • Pregnancy
  • A lot of weight gain.

Paraesophageal hernias often do not display any symptoms, but when symptoms are present, they can include:

  • Heartburn related to gastroesophageal reflux disease (GERD)
  • Sudden severe chest pain
  • Radiating chest pain that doesn’t go away after taking an antacid
  • Difficulty swallowing
  • Stomach pain
  • Indigestion
  • Nausea
  • Vomiting
  • Retching

Testing

There are several tests that can find a paraesophageal hernia:

  • Endosocopy – the doctor passes a thin, flexible tube with a light and video camera down the throat and into the esophagus and stomach to check for inflammation.
  • Barium swallow – liquid is swallowed while an x-ray of the digestive tract is taken.
  • CT or MRI

Treatment

Most people don’t need treatment unless they experience recurrent heartburn and acid reflux. Surgery may be done if the hiatal hernia is in danger of becoming constricted or strangulated so that the blood supply is cut off. If that happens, surgery that doesn’t require major cutting or opening of the body (minimally invasive) can be done thru a laparoscopic procedure.

hernia
Paraesophageal hernia