title: Combination of hiatal hernia with nonspecific esophageal motility disorder (NEMD) successfully treated with thoracic and abdominal surgery: report of a case.
abstract: A 74-year-old woman was admitted to Gunma University Hospital because of dysphagia symptoms. A gastrointestinal contrast study demonstrated a large esophageal hiatal sliding hernia affecting the passage of barium at the lower end of the esophagus. Manometric studies showed hypotensive pressure in the lower esophageal sphincter (LES) and relaxation failure of the LES during swallowing. We diagnosed a combination of sliding hiatal hernia with nonspecific esophageal motility disorder (NEMD). Thoracoscopically assisted Heller myotomy and Dor fundoplication by abdominal open surgery were then performed. The patient is currently well and is free from dysphagia symptoms. Treatment with combination thoracoscopic and abdominal open surgery was effective. We report here the first case of combined hiatal hernia with NEMD treated by thoracoscopic and abdominal open surgery.
authors.affiliation: Department of General Surgical Science, Gunma University Faculty of Medicine, Maebashi, Japan. msohda@med.gunma-u.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Mariko
authors.initials: M
authors.lastname: Sakai
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Suzuki
authors.forename: Naritaka
authors.initials: N
authors.lastname: Tanaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakai
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sano
authors.forename: Takanori
authors.initials: T
authors.lastname: Inose
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000368:Aged; D015154:Esophageal Motility Disorders / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D018662:Fundoplication / Q000379:methods; D006551:Hernia, Hiatal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D013906:Thoracoscopy