https://scholars.lib.ntu.edu.tw/handle/123456789/539032
標題: | Clinical implication of hiatal hernia in patients with right isomerism | 作者: | Hsu J.-Y. SHYH-JYE CHEN JOU-KOU WANG YEN-HSUAN NI MEI-HWEI CHANG MEI-HWAN WU |
公開日期: | 2005 | 卷: | 94 | 期: | 9 | 起(迄)頁: | 1248-1252 | 來源出版物: | Acta Paediatrica, International Journal of Paediatrics | 摘要: | Objective: Despite a reported association between hiatal hernia in patients with heterotaxy syndrome, the clinical significance has remained unclear. Based on large patient cohorts, this study specifically aimed at defining the implication of hiatal hernia in patients with right isomerism. Methods: From 1994 to 2002, 143 patients were identified as having right isomerism. Among them, 119 received ultrafast computed tomography (CT) to determine the presence of hiatal hernia as well as any cardiovascular anomalies. Results: Hiatal hernia was found in 17 patients (seven females and 10 males, 14.3%). The upper gastrointestinal (GI) series in six patients confirmed the diagnosis of hiatal hernia in all and revealed severe gastro-oesophageal reflux in four. The most common symptom of hiatal hernia was vomiting (47%), followed by recurrent bronchiolitis or pneumonia (41.2%) and upper gastrointestinal bleeding (11.8%). Three patients with hiatal hernia underwent fundoplication for medically refractory vomiting. Seven patients were found to have midgut malrotation (5.9%), and four of these had both hiatal hernia and malrotation. Pulmonary atresia was closely associated with the presence of hiatal hernia (p = 0.02). One patient with hiatal hernia died suddenly at 6 mo. However, overall mortality was similar between those patients with hiatal hernia and those without. Conclusions: The incidence of hiatal hernia was considerably high in patients with right isomerism, especially in those with pulmonary atresia, and it is this that may have led to vomiting and recurrent airway infections. While an association between sudden death and hiatal hernia may well exist, this does require further clarification. ? 2005 Taylor & Francis Group Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-27144538276&doi=10.1080%2f08035250510031458&partnerID=40&md5=3e2b6b2d6792dd672820d7282810ea80 https://scholars.lib.ntu.edu.tw/handle/123456789/539032 |
ISSN: | 0803-5253 | DOI: | 10.1080/08035250510031458 | SDG/關鍵字: | accessory spleen; article; asplenia; bronchiolitis; cardiovascular malformation; child; clinical feature; cohort analysis; controlled study; electron beam tomography; female; gastroesophageal reflux; gastrointestinal hemorrhage; heterotaxy syndrome; hiatus hernia; human; intestine malrotation; lung atresia; major clinical study; male; mortality; pneumonia; priority journal; recurrent disease; sample size; stomach fundoplication; sudden death; vomiting; Abnormalities, Multiple; Adolescent; Adult; Child; Child, Preschool; Cyanosis; Death, Sudden; Female; Gastroesophageal Reflux; Gastrointestinal Hemorrhage; Gastrointestinal Tract; Hernia, Hiatal; Humans; Infant; Infant, Newborn; Male; Respiratory Tract Infections; Spleen; Stomach; Survival Rate; Tomography, X-Ray Computed; Vomiting |
顯示於: | 醫學系 |
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