title: "True" parahiatal hernia: a rare entity radiologic presentation and clinical management.
abstract: BACKGROUND
  True parahiatal diaphragmatic hernias are rare entities that are sparsely accounted for in the literature. The current report is intended to depict the clinical profile and assess the feasibility of laparoscopic repair of parahiatal hernias.
  
  
  METHODS
  We conducted a retrospective review of all patients diagnosed and treated for parahiatal hernias. Clinical presentation and radiological assessment, as well as operative findings and repair, are discussed.
  
  
  RESULTS
  Of the 917 laparoscopic hiatal hernia repairs, 2 (0.2%) patients were identified with a parahiatal hernia. The presenting symptoms and preoperative testing were similar to those with more common paraesophageal hernias. Laparoscopic repair was successful in repairing the diaphragmatic defect and alleviating symptoms up to 4 years postoperatively.
  
  
  CONCLUSIONS
  Parahiatal hernias of the diaphragm appear to be rare primary diaphragmatic defects. The clinical presentation of parahiatal hernias is often indistinguishable from the more common paraesophageal pathology. Laparoscopic repair of this rare entity can be safely and successfully accomplished in conjunction with antireflux surgical interventions when indicated.
authors.affiliation: Divisions of General Thoracic and Minimally Invasive Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Scheidler
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Keenan
authors.forename: Richard H
authors.initials: RH
authors.lastname: Maley
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wiechmann
authors.forename: Dennis
authors.initials: D
authors.lastname: Fowler
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Landreneau
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000601:surgery; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome