Hiatal Hernia Repair Simultaneously Performed with PEG for the Purpose of Long-term Nutritional Control—A Report of Two Cases—

Abstract

Percutaneous endoscopic gastrostomy (PEG) has great benefits in terms of nutritional control and ingestion, and it tends to be accepted by nursing homes. Contrary to an increasing tendency of PEG cases, other enteral nutritional methods are often selected if hiatal hernia is associated. We have recently experienced two cases of a hiatal hernia in which we performed laparoscopic hernia repair followed by PEG. This paper reports on the benefits of the PEG based on our experience.

Case 1 involved a 79-year-old woman who had been received enteral nutrition via a NG-tube for difficulty in swallowing due to dementia and cerebral infarction. Since the patient needed long-term nutritional support, we performed laparoscopic repair of the hiatal hernia (Type II), followed by PEG. Case 2 involved an 87-year-old woman who had difficulty in swallowing due to dementia and aging. As she had frequent bouts of aspiration pneumonia, we performed laparoscopic repair of the hiatal hernia (Type IV), followed by PEG. Two patients were discharged from our hospital without having aspiration pneumonia and/or worsening of the nutritional status.

We can select laparoscopic repair of hiatal hernia followed by PEG, even for patients who have a hiatal hernia.