PARAESOPHAGEAL HERNIA SYMPTOMS, A NEGLECTED CLINICAL ENTITY okorn@hcuch.cl

PW02-07

PARAESOPHAGEAL HERNIA SYMPTOMS, A NEGLECTED CLINICAL ENTITY

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Chile

Oral or Poster

Paraesophageal hernias (PEH), encompassing types II, III, and IV, have traditionally been regarded as an extension of type I hiatal hernias and are commonly evaluated using gastroesophageal reflux disease criteria. Nowadays, there is interest in evaluating the specific symptoms of HPE. Our objective was to describe the symptoms of HPE in a Chilean population.

This prospective, descriptive, observational study included patients undergoing surgical repair for PEH between 2019 and 2024 at the Clinical Hospital University of Chile. Institutional protocol mandates surgical intervention for all diagnosed cases of PEH. Data were extracted from electronic medical records and a standardized survey administered on the first postoperative day, documenting preoperative symptoms. Statistical analysis was performed with a significance level set at p < 0.05.

A total of 100 consecutive patients were included; 81% were female, with a median age of 64 years (range 33–88). Type III hernia was the most prevalent subtype (69%). All patients reported symptoms, ranging from 3 to 17 per individual, with a modal value of 9 symptoms. The most commonly reported symptoms were avoidance of late meals (71%), heartburn (70%), and early satiety (69%). Less frequent symptoms included odynophagia (23%), water brash (22%), and upper gastrointestinal bleeding (16%).

PEH is associated with a broad spectrum of clinical manifestations that extend beyond typical GERD symptoms such as heartburn and regurgitation. These findings underscore the substantial impact of PEH on patients’ quality of life and support surgical intervention, not only for the prevention of complications but also for symptomatic relief.