A 20-year prospective follow-up of childhood hiatal hernia.
A long-term prospective follow-up of 113 children with vomiting due to a small hiatal hernia is described. When reviewed by the same clinical and radiological observers 20 or more years later, over 90% of unoperated non-stricture patients were asymptomatic whereas only 44% of the stricture and/or surgically treated group were without symptoms. Half or possibly more of the asymptomatic patients still had a hernia and it is possible that these may suffer a recurrence of symptoms later in adult life. The loculus of thoracic stomach tended to retain the same shape; there was a slightly better prognosis for the locular type of hernia compared with the tubular type. Complicating oesophageal strictures can decrease or disappear without surgery other than dilatation; the results of treatment by radical surgery were disappointing. There is need for an even more prolonged follow-up into later adult life.
D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006548:Hernia, Diaphragmatic / Q000601:surgery; D006551:Hernia, Hiatal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D011446:Prospective Studies; D011859:Radiography; D012075:Remission, Spontaneous; D014839:Vomiting / Q000209:etiology