Key result
Laparoscopic crural repair successfully resolves post-aortic surgery hiatal hernia with zero recurrence at 11 months.
Why the study?
Iatrogenic hiatal hernia after non-esophageal abdominal surgery is exceedingly rare in children and had not been previously reported after aortic surgery.
Case Report (n=1)
Unrepaired division of the diaphragmatic crus during open aortic surgery in children can lead to a large iatrogenic hiatal hernia, which should be prevented by primary crural repair or can be successfully treated via laparoscopic crural closure.
Answers are grounded in this paper and cite their sources.
Raises awareness of hiatal hernia risk after pediatric aortic procedures with crural incision; leaves open incidence and preventive strategies.
Introduction Iatrogenic hiatal hernia after non-esophageal abdominal surgery is exceedingly rare in children, and to our knowledge it has not been previously reported after aortic surgery. Case Presentation A term female underwent mitral valve repair at 10 months. At 15 months a stent was placed to treat aortic coarctation which migrated to the supraceliac aorta within 24 hours. She underwent thoracotomy for coarctation repair and laparotomy for stent retrieval, which required left crural division, and the hiatus was not repaired. At approximately 18 to 20 months, she developed intermittent cough and gurgling over the left upper abdomen. At 21 months, she had bleeding gastric ulcers from aspirin with severe anemia. At 23 months, surveillance computed tomography angiography (CTA) incidentally showed a large hiatal hernia and recurrent coarctation. After endovascular stenting, she underwent four-port laparoscopic repair with posterior and anterior crural closure (2-0 Ethibond™) over a 36 Fr bougie. She was discharged on postoperative day one. At 11-month follow-up, CTA showed no hernia recurrence, her symptoms and anemia had resolved, and her growth was normal. Conclusion Patients who undergo open aortic surgery requiring division of the diaphragmatic crus are at risk of developing a postoperative hiatal hernia if the crus is not repaired at the conclusion of the procedure.
No takes yet. Share an insight, caveat, or question.
Tahir et al. (2026) conducted a case report in Iatrogenic hiatal hernia and recurrent aortic coarctation following open coarctation repair and stent retrieval (n=1). Four-port laparoscopic hiatal hernia repair with posterior and anterior crural closure over a 36 Fr bougie following endovascular aortic stenting was evaluated on Hiatal hernia recurrence, symptom resolution, and growth at 11-month follow-up. Laparoscopic crural closure over a 36 Fr bougie resolved an iatrogenic hiatal hernia in a 23-month-old infant after aortic surgery, with no recurrence at 11-month follow-up.
Synapse has enriched 10 related papers. Consider them for comparative context: