{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:33:44Z","timestamp":1787070824624,"version":"build-2736575974"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Congenital paraesophageal hernia is a rare condition in the pediatric population, with giant hiatal hernia (HH) being even more uncommon. We report a case of a 3-year-old male who presented with epigastric pain after meals, recurrent respiratory symptoms, early satiety, and a history of pneumonia. Imaging studies, including a chest X-ray, upper gastrointestinal (UGI) contrast study, and contrast-enhanced computed tomography thorax, confirmed a sliding HH. The laparoscopic evaluation revealed 80% of the stomach herniating into the thoracic cavity through lax esophageal hiatus contained in a sac. The patient underwent UGI endoscopy and laparoscopic reduction of contents, sac excision, diaphragmatic crural repair, and Thal\u2019s anterior fundoplication. Postoperative recovery was uneventful, with the patient remaining asymptomatic on follow-up. Congenital paraesophageal hernias are believed to arise from embryologic abnormalities and often present with atypical symptoms, such as respiratory distress, making early diagnosis challenging. The etiology can be confirmed only after ruling out all the acquired causes of HH. Surgical intervention is the preferred treatment, particularly in cases of giant HH, to prevent complications such as volvulus and obstruction. Adhering to key surgical principles \u2013 including complete hernia reduction, crural repair, and an appropriate antireflux procedure \u2013 ensures optimal outcomes. This case highlights the rarity of congenital giant HH in children and its unusual presentation with predominant respiratory symptoms. Laparoscopic repair, following established surgical principles, proved to be an effective and minimally invasive approach, leading to a successful outcome.<\/jats:p>","DOI":"10.4103\/jiaps.jiaps_78_25","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T03:00:10Z","timestamp":1751338810000},"page":"667-670","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Giant Congenital Hiatal Hernia in a Child \u2013 A Rarity"],"prefix":"10.4103","volume":"30","author":[{"given":"Keerthana","family":"Bachala","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, AIIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit Kumar","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, AIIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashi","family":"Rashi","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, AIIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, AIIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahil Najeeb","family":"Kassim","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, AIIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyas","family":"Dudhani","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, AIIMS, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"R1-20250901","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.bpg.2007.12.007","article-title":"Approaches to the diagnosis and grading of hiatal hernia","volume":"22","author":"Kahrilas","year":"2008","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"R2-20250901","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1016\/j.jpedsurg.2006.05.020","article-title":"Primary paraesophageal hernia in children","volume":"41","author":"Karpelowsky","year":"2006","journal-title":"J Pediatr Surg"},{"key":"R3-20250901","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.jpedsurg.2018.07.008","article-title":"Congenital paraesophageal hernia:Contemporary results and outcomes of laparoscopic approach to repair in symptomatic infants and children","volume":"54","author":"Petrosyan","year":"2019","journal-title":"J Pediatr Surg"},{"key":"R4-20250901","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.jpedsurg.2005.03.060","article-title":"Congenital paraesophageal hiatal hernia:Pitfalls in the diagnosis and treatment","volume":"40","author":"Imamo\u011flu","year":"2005","journal-title":"J Pediatr Surg"},{"key":"R6-20250901","first-page":"171","article-title":"Congenital hiatus hernia:A case series","volume":"6","author":"Embleton","year":"2019","journal-title":"North Clin Istanb"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_78_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:37:14Z","timestamp":1787067434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_78_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":5,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_78_25","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"assertion":[{"value":"2025-03-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}