StatPearls-/-ä 2024[Jan]; ä (ä): ä PMID33620801show ga
Parahiatal hernia (PHH) is a rare type of diaphragmatic hernia (DH), which is an abnormal protrusion of the viscera through an abnormal diaphragmatic defect between the left part of the right crus and the left crus. The diaphragm is a vital muscle for breathing, derived from the septum transversum (anterior portion), pleuroperitoneal folds (posterolateral part), and dorsal mesentery (posteromedial part). This anatomical barrier between the two cavities has normal openings for various structures to pass through. The hiatal opening at the 10th thoracic vertebral level allows the esophagus to pass through its right crus to form a gastroesophageal junction (GOJ). A PHH defect would occur to its left side. Due to the proximity, PHH always gets confused with a hiatus hernia. (see Image 1) Hiatus Hernia The majority of diaphragmatic hernias are hiatal defect. The most prevalent of them are the sliding type, due to cephalad migration of GOJ (Type I), less frequent variant is paraesophageal in nature due to rolling of the stomach may be without any migration of GOJ (Type II) or with the migration of GOJ (Type III) and in the worst case, it is associated with herniation of other abdominal viscera along with stomach (Type IV). The distinctive feature of the hiatal hernia is an abnormal protrusion of the viscera through a normal opening (Oesophageal hiatus) in contrast to PHH. In general, the stomach is the only herniated content, but other contents can be found, including transverse colon, omentum, small bowel, and the spleen.
StatPearls-/-ä 2024 ; ä (ä): ä
