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October 1959

Balanced Operations for Esophagitis Associated with Hiatal Hernia en Masse

Author Affiliations

From the Departments of Surgery of the Marion County General Hospital and the Methodist Hospital.

AMA Arch Surg. 1959;79(4):548-552. doi:10.1001/archsurg.1959.04320100014003

In a previous communication1 we described balanced operations in the treatment of persistent esophagitis associated with esophageal hiatal hernia. We also referred to previous discussions2,3 concerning the classification of associated lesions with hiatal hernia and to theories concerning its probable pathogenesis. We defined esophageal hiatus hernia of the so-called sliding or short esophageal type as a cephalad displacement of the cardia above the diaphragm and called attention to associated infradiaphragmatic lesions. Hiatal hernia en masse is also a malfunction of several of the derivatives of the foregut; the parts of the alimentary canal nourished mainly by blood from the celiac axis and concerned principally with digestion. Thus, in a significant number of patients with hiatal hernia en masse there is an associated esophagitis, duodenal or gastric ulcer, biliary tract disease, and pancreatitis.

Paraesophageal, parahiatal, or rolling type of hernia is defined as a hernia through the diaphragm in

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