Congenital mixed hiatal hernia: A case report of an atypical cause of neonatal vomiting

JPGN reports Pub Date : 2024-01-25 DOI:10.1002/jpr3.12042
Katia N. Estrada‐Medrano, Sergio J. Fernández‐Ortiz, Oscar Tamez-Rivera, E. Villarreal
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Abstract

Congenital mixed hiatal hernia is a disorder that combines features of both sliding and paraoesophageal hernias. The precise incidence of congenital mixed hiatal hernia during the pediatric and neonatal period remains uncertain, making diagnosis challenging within this age cohort. This case presents a 15‐day‐old female with an 8% postnatal weight loss and apost‐feeding vomiting. An upper gastrointestinal series, computer tomography, and upper endoscopy revealed a mixed hiatal hernia. The patient underwent a laparoscopic herniorrhaphy and Nissen fundoplication achieving successful resumption of complete oral feeding before discharge. Diagnosis and management of this condition in neonates remain challenging due to its rarity and variable clinical presentations. This report emphasizes the importance of early recognition, accurate diagnosis, and tailored management strategies in the neonatal period. Further research, with a collaborative effort between pediatricians and surgeons, is needed to refine diagnostic criteria, establish evidence‐based management approaches, and improve outcomes for affected children.
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先天性混合性裂孔疝:新生儿呕吐的非典型病因病例报告
先天性混合食管裂孔疝是一种兼具滑动食管疝和副食管疝特征的疾病。先天性混合食管裂孔疝在小儿和新生儿期的确切发病率仍不确定,因此在这一年龄组中进行诊断具有挑战性。本病例是一名出生后 15 天的女性,体重下降了 8%,并伴有喂养后呕吐。上消化道系列检查、计算机断层扫描和上内镜检查显示患者患有混合性食管裂孔疝。患者在出院前接受了腹腔镜食管裂孔成形术和尼森胃底折叠术,成功恢复了完全口喂。由于新生儿食管裂孔疝的罕见性和临床表现的多变性,该病的诊断和治疗仍具有挑战性。本报告强调了新生儿期早期识别、准确诊断和定制管理策略的重要性。我们需要儿科医生和外科医生通力合作,进一步开展研究,以完善诊断标准,建立循证管理方法,改善患儿的预后。
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