Giant hiatus hernia without gerd

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

rabbitrabbit
New Member


Date Joined Jun 2010
Total Posts : 6
   Posted 6/23/2010 8:08 PM (GMT -6)   
Hello, does anyone have any experience of surgery on a hiatus hernia where the stomach has gone almost completely into the chest cavity please? In this case, there is no apparent acid problem,  just occasions where food 'jams' .

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 6/23/2010 8:41 PM (GMT -6)   
My aunt had surgery for it. Also Alica who posts here had surgery for it recently.

Joy

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 6/24/2010 6:44 AM (GMT -6)   
rabbitrabbit-
Welcome to Healing Well. Joy is correct Alcie did have this problem after a car accident if I remember correctly. I am sure she will be along shortly also.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09


StaceyA
Regular Member


Date Joined Feb 2010
Total Posts : 114
   Posted 6/24/2010 11:18 AM (GMT -6)   
I had the nissen fundo due to a very large paraesophageal hernia. Tests showed GERD, but I was without symptoms from it.
Best of luck!
Stacey

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5012
   Posted 6/24/2010 11:53 AM (GMT -6)   
Yes, I did have this happen due to seatbelt and airbag in a high speed wreck.

Because I was already on PPIs I had had non-acid reflux for at least 25 years and no bad acid erosions, I would not have had surgery but for the accident. I already had a small hiatal hernia, but those are of no significance normally and just about everyone gets them at some time. I have a weak swallow due to having polio as a child, so I can't swallow large pills and have had trouble with chunks of meat that were not chewed well enough.

However, a paraesophageal hernia, where the stomach stays in the chest, is dangerous. If the stomach rotates it can start dying immediately and you have to be rushed into surgery with only a 50% chance of survival. Since it will not correct itself, a paraesophageal hiatal hernia is a clear indication that surgery is necessary.

This surgery is done exactly like the Nissen fundoplication, laparoscopically. Since the stomach has to be pulled down from the chest carefully, it takes a good bit longer (mine took 4 1/2 hours), but is probably no more dangerous in the hands of a top, experienced surgeon. I was not the best candidate for any surgery because of a previous heart attack and my age, but my surgeons are tops in their field here in Pittsburgh, and I had a good outcome.

I wouldn't recommend going to a surgeon who hasn't done thousands of these procedures for a paraesophageal hernia. Less esperience is probably fine for routine surgeries, but this one takes a bit of doing to get it right. Since I don't have a strong swallow, the procedure selected for me was called a Toupet fundoplication. It's a partial wrap done in the same manner as the Nissen.

Let the surgeon choose the procedure based on your tests, but there's no question that surgery is necessary for a stomach stuck in the chest.
Alcie
 
 


JAS1125
New Member


Date Joined May 2010
Total Posts : 15
   Posted 7/2/2010 10:26 PM (GMT -6)   
I'm 4 weeks post surgery for the same thing as Alcie (same area too, Pittsburgh!)
In my case, I did have reflux bad for some time before I wised up and went to a gastro.....PPI seemed to alleviate the problem as well as diet changes. I did however, have a large hiatal hernia that became a para-esophageal one that was reduced one month ago. I was having some pretty severe stomach spasms that were increasing in magnitude. No issue swallowing but I would get a gas bubble "stuck" and couldn't burp to relieve it. During the surgery a Nissen floppy wrap was to be done, but the surgeon could not since I have a "short" esophagus, however my surgeon felt that the hernia was so large (giant-sized) it was the main cause of my reflux.
As of now, still on a soft food diet, with another follow up and chest x-ray next week to see if everything is still where it's supposed to be.
My surgery, also done via laproscope, took about 3 hours.

All that being said, I completely agree with Alcie.....you need to have this corrected by surgery or it will continue to get larger and worse.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5012
   Posted 7/3/2010 9:58 AM (GMT -6)   
Pittsburgh's a good place to get this surgery done. 3 docs in different hospitals have enough experience here. Mine was done at Presby.

JAS - If the stomach spasms didn't go away or they come back, check into food triggers. Keep a food log. With paraesophageal that alone causes serious problems. You aren't far enough along yet to know.
Alcie
 
 


JAS1125
New Member


Date Joined May 2010
Total Posts : 15
   Posted 7/3/2010 11:02 AM (GMT -6)   
Alcie said...
Pittsburgh's a good place to get this surgery done. 3 docs in different hospitals have enough experience here. Mine was done at Presby.

JAS - If the stomach spasms didn't go away or they come back, check into food triggers. Keep a food log. With paraesophageal that alone causes serious problems. You aren't far enough along yet to know.


My insurance excluded Presby,so I went with the 2nd surgeon on my recommended list. He's out of AGH as well as St. Clair. He also did a Nissen wrap and hernia repair on a good friend too.

I was keeping track before all this happened, but could not find a food trigger. Negative testing for celiac disease and food allergies, but as my food intake goes up, I'm going to try again.
Thanks Alcie

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5012
   Posted 7/3/2010 4:17 PM (GMT -6)   
JAS - Are you still on PPIs? I was on for 2 weeks post-op, then allowed to go off if I didn't need them. My only complaint was the 2 week post-op check was the only one. Patients are dumped. I called about diet, but they're only interested in whether they can put my surgery in the success column. But then my GI doc has been useless for anything about diet too. He just wants me to go to his clinic for my next colonoscopy, and I'm not sure I want to.
Alcie
 
 


JAS1125
New Member


Date Joined May 2010
Total Posts : 15
   Posted 7/3/2010 4:36 PM (GMT -6)   
Still on PPI's...Dexilant now, as Protonix stopped working. Prior to surgery, my GI still wanted me to stay on them, and I'm due for my follow up scope in October. Interestingly, the surgeon stated that my Barrett's was "spotty" and not completing covering the area indicated on the last scope. That was different than my results last year, so I'm hopeful that there's an improvement. The GI should be able to tell, I assume.
My 2nd f/u is next Friday, along with a chest x-ray so we'll see how many more I have beyond that.
Colonoscopy is due for me this year also, but I think I'll defer until next year. My 1st was done by a different surgeon and I'll return to him for it.

Sounds to me like you should shop for a new gastro...I know of several in the South Hills (if you are near there) if you need some names

rabbitrabbit
New Member


Date Joined Jun 2010
Total Posts : 6
   Posted 9/16/2010 12:04 PM (GMT -6)   
Hello again. Thank you all for your replies. Sorry for the delay. Im in Uk so things may be different I dont know . The first specialist my husband saw , told him surgery was absolutely necessary because the whole stomach was in the chest. He told us it was 'urgent' because if it strangulated , it reduced survival rates significantly . He told us open surgery was necessary in this case because of scar tissue from a previous triple A op, and that he recommended a thoracic surgeon to do it because it was big and tricky ---- he would get things moving.
We waited weeks. Nothing. Then we found out that surgeon had retired without making the necessary requests to get my OH an urgent appointment, so it was just too bad, we had to wait till now , today for one.
This specialist today, was totally laid back. Yes it was huge,already flipped back on itself in the chest cavity, needed doing, but no, it would wait another month or two, yes he fully intends to do it keyhole way-hes done other giants that way, and dont worry, strangulation rarely happens in reality , and even if it did, OH would just come in straight away, have a tube inserted down the oesophagus to deflate stomach, and then a normal hernia op would be carried out. No it wouldnt increase mortality rate. What the heck are you supposed to believe!

rabbitrabbit
New Member


Date Joined Jun 2010
Total Posts : 6
   Posted 11/5/2010 7:40 PM (GMT -6)   
Hello again. Just thought I would post that my OH  got to his operation date without  stangulation!   He had his surgery yesterday finishing at 4pm . Four hour job and six keyholes, as the whole stomach was totally sitting in chest cavity, squashing the lungs.  A full wrap was done and to my astonishment, I visited an hour after he came out of recovery, and he was being walked to the toilet. Brilliant.  Lot of centre of chest pain by the evening, which they said was mostly wind, and pain around the shoulder which they said was where the nerve endings are for the diaphragm , and  trapped gas was sitting under the diaphragm irritating it. He had morphine last night to help that discomfort. Today he ate  very thin wheatabix mush   for breakfast , a few spoonfools of thin mince mashed peas and mashed potato for lunch , and they rang me to come and take him home  this afternoon.  Exactly 24hrs from exiting theatre. Im so pleased . So far so good! Hes on meds to stop him vommiting , and I have seen that he is doing small burps from time to time so the wind is gradually dissipating. Mustnt count chickens too soon of course, but so far he says it hasnt been as bad as he had feared.  Good luck to others about to have their ops.
New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, July 18, 2018 4:04 AM (GMT -6)
There are a total of 2,982,750 posts in 327,122 threads.
View Active Threads


Who's Online
This forum has 161857 registered members. Please welcome our newest member, zssaq.
247 Guest(s), 4 Registered Member(s) are currently online.  Details
prx46031, axe65613, zssaq, Subdenis