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Mechanisms of dyspnoea in giant hiatus hernia: an indication to perform surgery?

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Summary

Background

The physiology of dyspnoea associated with giant hiatus hernia has not been well understood; however, it is generally considered a contraindication for surgery.

Methods

Recent studies into mechanisms and prevalence of dyspnoea are discussed.

Results

Recent studies suggest that dyspnoea is present in 80% of cases of massive hiatus hernia. Cardiac compression from massive hiatus hernia is a known contributor to dyspnoea in this patient group, as well as pulmonary aspiration.

Conclusions

Paradoxically, dyspnoea could be considered as an indication for surgery in patients presenting with giant hiatus hernia, once the mechanism is established.

Novel points

Dyspnoea in the presence of a substantially large hiatus hernia has long been considered unrelated and a contraindication to surgery. We present the results of varied studies that suggest dyspnoea, when the mechanism is established, is in fact an indication for surgery in giant hiatus hernia.

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Acknowledgements

We would like to thank co-workers Professor John Yiannikas and Dr Christopher Naoum, from the Department of Cardiology, Repatriation General Hospital Concord, NSW, Australia.

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Authors and Affiliations

  1. Sydney Heartburn Clinic, Suite 29, 12–18 Tryon Rd, NSW 2070, Lindfield, Australia

    Gregory Leighton Falk MBBS FRACS FRCS & Sophia C. Little B. AVBS (Hons)

  2. Repatriation General Hospital Concord, NSW 2137, Concord, Australia

    Gregory Leighton Falk MBBS FRACS FRCS

Authors
  1. Gregory Leighton Falk MBBS FRACS FRCS
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  2. Sophia C. Little B. AVBS (Hons)
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Corresponding author

Correspondence to Gregory Leighton Falk MBBS FRACS FRCS.

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Conflict of interest

G.L. Falk and S.C. Little declare that they have no competing interests.

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Falk, G.L., Little, S.C. Mechanisms of dyspnoea in giant hiatus hernia: an indication to perform surgery?. Eur Surg 50, 167–168 (2018). https://doi.org/10.1007/s10353-018-0531-3

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  • DOI: https://doi.org/10.1007/s10353-018-0531-3

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