| Discussion in 'All Categories' started by Louise Katz - Jul 20th, 2011 11:58 am. | |
Louise Katz
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July 20 2011 Patient: Louise Katz, 78-yr old female living in Wellington, Florida; Weight 89lbs Height 4’10” Objective: Seeking a thoracic surgeon with strong experience in repair of a giant hiatal hernia. “A massive diaphragmatic hernia contains most of the stomach and the distal transverse colon. Mild/moderate distention of the colon within the diaphragmatic hernia sac is observed.” Louise became aware of her large hiatal hernia when after a painful attack about 1995, she was taken to the ER in Pascack Valley Hospital, Westwood, NJ. After investigating the possibility of surgery she decided against it. Subsequent attacks during the next few years were treated with pain alleviating drugs. She has not suffered an attack in the last seven to ten years. On June 6, 2011, after weeks of discomfort on the left side of her abdomen, she had a CT performed on the abdomen. The results showed the existing hernia mentioned above in addition to what appeared to be 3.0 cm mass in the head of the pancreas. An upper EUS scheduled days later failed to reach and observe the pancreas because of the anatomic obstruction. However, the procedure triggered an immediate inflammation of the entire area including the pancreas, sending her without delay to the ER and a hospital stay for ten days for what was initially diagnosed as pancreatitis. Subsequent CT scans at the hospital failed to show any sign of a mass in the pancreas, instead showing: “a moderate intrahepatic biliary dilatation”. She was given morphine in the hospital. At home she is being weaned very slowly off morphine but continues to eat very little and suffers from sharp pain in the left shoulder upon eating. Three hospital house physicians, three gastroenterologists, and her primary doctor have suggested no other treatment than to permit the inflammation to cool off and that she find and consult recognized specialists at leading medical centers for further treatment. She was warned that any invasive procedure will cause the same or worse symptoms to appear again. Dr. Ribeiro of U of Miami Med Center examined Louise on July 18th as well as the digital scans on the disk of most recent CT scan. He confirmed that the problem with the pancreas were minimal and that her most serious problem was the giant hiatal hernia containing her stomach and part of the colon. He was concerned as to whether such a large opening could be surgically repaired. We are seeking a thoracic surgeon who has experience in repairing giant hiatal hernias. It is preferred to send information such as the disk covering the latest CT scan as well as any other desired information in advance of a visit in order to determine if Louise is a candidate for surgery. Insurance includes Medicare and Blue Cross Blue Shield |
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re: Giant Hiatal Hernia with part of colon in chest
by richard owens -
Jul 25th, 2011
1:58 pm
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richard owens
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I have a large sliding Hiatal hernia that is giving me pain in my abdomen,also having a hard time eating very much and discomfort in my side. Do you have any advise? Thank You, Richard Owens |
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re: Giant Hiatal Hernia with part of colon in chest
by Dr Sadhana -
Jul 25th, 2011
8:45 pm
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Dr Sadhana
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Dear Katz Patient with a giamt hiatal hernia who also have severe, chronic esophageal reflux may need surgery to correct the problem if their symptoms are not relieved through medical management techniques. Sometime mesh is also necessary to use to repair these GPEH. Our hospital can offer this surgery to your patient. During laparoscopic surgery, gastroesophageal reflux and herniation of abdominal organ in chest is corrected by pulling the hiatal hernia back into the abdomen and creating an improved valve mechanism at the bottom of the esophagus. Hiatal hernia surgery can be performed as a laparoscopic or minimal access surgical procedure. During laparoscopic surgery, five or six small incisions are made in the abdomen. The laparoscope and surgical instruments are inserted through these incisions. The laparoscopic surgeon is guided by the laparoscope, which digitally transmits a picture of the internal organs on a TV monitor. The main advantages of laparoscopic surgery over open surgery include smaller incisions, less risk of infection, less pain and scarring, and a more rapid recovery. You can go ahead and upload the picture of your patient investigations to our website and our consultant can give you the best advice about all the quesry related to surgery. With regards Sadhana |
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re: Giant Hiatal Hernia with part of colon in chest
by Paireebiz -
Oct 5th, 2011
5:55 am
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Paireebiz
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TEst progon bbbb 344 bab |
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re: Giant Hiatal Hernia with part of colon in chest
by gronrelve -
Oct 19th, 2011
3:16 pm
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gronrelve
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re: Giant Hiatal Hernia with part of colon in chest
by palpbaway -
Oct 23rd, 2011
6:46 pm
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palpbaway
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