Para esophageal hernia ( stomach in thoracic chest)

Posted by healthy101 @healthy101, Mar 2 11:29am

I have been managing through lifestyle changes and proton pump inhibitors my stomach being “sucked” up into my chest. Also known as an “intra-thoracic stomach”.
Anyone else living with their stomach in their chest? I don’t want to have surgery if I can avoid it. I don’t want to be on PPIs the rest of my life either. I am a 69 yrs old female. I have a large hiatal hernia. Do I need a thoracic surgeon or a general surgeon? I also have a ventral hernia from previous abdominal open surgery that I would like to have repaired. Any perspective or opinions will be much appreciated regarding managing or surgical intervention of living with an intra- thoracic stomach. Thanks!

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Get an appointment at Mayo.
If you need surgery this is the place to go.

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Hello @healthy101 and welcome to Mayo Connect. I'm glad to see that you are making lifestyle changes and using PPI meds to help control this problem. Most of us would prefer to avoid surgery if at all possible. I'm wondering what symptoms are most bothersome for you right now? Has a particular type of surgery been discussed?

As mentioned by @riflemanz64 it is a good idea to get a second opinion regarding surgery. Going to a multi-disciplinary health organization like Mayo Clinic is a good way to get an opinion on the best options available. If you would like to have a consult with a Mayo doctor, at any of their three locations, here is a link that will facilitate making an appointment, http://mayocl.in/1mtmR63.

How long ago were you diagnosed with this problem, @healthy101?

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I was diagnosed with a large hiatal hernia with 1/2 of my stomach up in my thoracic cavity 2 years ago. A year ago I ended up in my local small town ED and a CT scan showed 100% of my stomach in my thoracic cavity. I have read clinical research publications ( I am an RN) and think I need someone to help me with “shared decision making” on moving ahead with surgery. I would be more comfortable if I could have a hiatal hernia repair with a fundoplication, partial wrap then having an open procedure. I definitely don’t want mesh placed. Having had open abdominal surgery in the past, there are concerns about adhesions which would necessitate an open procedure. I am hesitant to have an open procedure again- especially having my side cut open or even my abdomen as I have had radiation therapy to my pelvis 15 yrs ago. I guess I will continue to ponder my surgical risks versus being on PPIs. Thanks!

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I too have sliding hiatal hernia. My stomach goes up into my diaphragm. Surgery is a big deal for chest. Yes, I don't need surgery yet but if I did I would use thoracic surgeon. More important to worry about diaphragm and lungs. Just my thought.

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@beracha

I too have sliding hiatal hernia. My stomach goes up into my diaphragm. Surgery is a big deal for chest. Yes, I don't need surgery yet but if I did I would use thoracic surgeon. More important to worry about diaphragm and lungs. Just my thought.

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Thanks @beracha, my dilemma is trying to decide the risk versus benefit of surgery. Lungs wise I know my lungs likely don’t filly expand due to my stomach being in my chest. I am physically active. I am worried about developing cancer of the esophagus with micro droplets of stomach acid moving around due to stomach in my chest. I’ll likely get it repaired!

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I, too was found that 80% to 90% of my stomach was the hiatal hernia pushing up near my heart. I had GERD because of that. My family Dr sent me to a surgeon; Mayo Clinic gastroenterologist was OK with the surgeon's plan. Laparoscopically my stomach was placed back down and secured with a Linx magnet ring. It was a same day procedure. I have had Linx for two years now and feel good; GERD is completely gone also. The most difficult thing was getting Linx used to my eating food and opening and closing as food goes down. I'm happy I had the surgery done. Good Luck!

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I had a giant hiatal hernia replacement last March. It was done by computer assist. It was the worst decision I ever made in my life. The hiatal hernia was fixed, however, I now have gastroparesis ! I was never told that anytime you have surgery involving your stomach, there’s a good chance of getting gastroparesis. It’s ruined my entire life and there is no cure.

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@parrotlady

I had a giant hiatal hernia replacement last March. It was done by computer assist. It was the worst decision I ever made in my life. The hiatal hernia was fixed, however, I now have gastroparesis ! I was never told that anytime you have surgery involving your stomach, there’s a good chance of getting gastroparesis. It’s ruined my entire life and there is no cure.

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Thank you so much for sharing your experience. That is the type of information I am looking for. I am so sorry to hear of your suffering with gastroparesis.
The other concern I have is having the fundoplication wrap too tight. I am very hesitant to undergo surgery.

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@44tiredof19

I, too was found that 80% to 90% of my stomach was the hiatal hernia pushing up near my heart. I had GERD because of that. My family Dr sent me to a surgeon; Mayo Clinic gastroenterologist was OK with the surgeon's plan. Laparoscopically my stomach was placed back down and secured with a Linx magnet ring. It was a same day procedure. I have had Linx for two years now and feel good; GERD is completely gone also. The most difficult thing was getting Linx used to my eating food and opening and closing as food goes down. I'm happy I had the surgery done. Good Luck!

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Thank you for your reply. I know what the Lynx implant is. It sounds like you are doing well.
I am not a candidate for Lynx. Thank you very much for sharing your experience.

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@parrotlady

I had a giant hiatal hernia replacement last March. It was done by computer assist. It was the worst decision I ever made in my life. The hiatal hernia was fixed, however, I now have gastroparesis ! I was never told that anytime you have surgery involving your stomach, there’s a good chance of getting gastroparesis. It’s ruined my entire life and there is no cure.

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I had the exact experience. I was also sent home with a collapsed lung and had to return to the hospital to have it drained. Three years later I had to have another repair done. It has been a nightmare. I never heard of gastroparesis and now I deal with it everyday. Stay strong!

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