Impact of Hiatal Hernia on Pediatric Gastroesophageal Reflux Disease
Although the relationship between hiatal hernia (HH) and gastroesophageal reflux disease (GERD) has long been recognized, there are many unknown aspects to the long-term impact of HH on GERD in children. Inthat early detection and conventional treatment of sliding HH in children resulted in a favorable outcome for children with persistent vomiting . However, about one-third of the children without treatment continued to suffer from GERD after their fourth birthday with a 10% chance of developing an esophageal stricture. HH is defined as an axial displacement of the proximal part of the stomach through the diaphragmatic hiatus.
Type I HH is caused by widening of the muscular hiatal tunnel and circumferential laxity of the phrenoesophageal membrane, thus allowing the gastric cardia to herniate above the diaphragm.Adult patients with a large HH are known to be more prone to GERD development than those with a smaller HH. It has an estimated prevalence of 10-80%, and usually is asymptomatic. In infants and children, invasive procedures are not routinely used to diagnose GERD, but rather clinical signs and symptoms. Therefore, the incidence of HH could be under-diagnosed since the diagnosis of HH requires radiographic or endoscopic examinations. Read more……………..
OMICS Journals 