PEPTIC ESOPHAGITIS. ITS SURGICAL SIGNIFICANCE.

Esophagitis caused by the reflux of acid gastric juices through an incompetent sphincter at the junction of the esophagus with the stomach is now recognized as a common cause of upper abdominal and thoracic symptoms frequently simulating heart, stomach or gallbladder disease. While these symptoms are occasionally mild and transient, under certain circumstances permanent, irreversible and seriously disabling changes may occur in the lower esophagus. The usual cause is a sliding hiatal hernia. Although mild symptoms can often be relieved by simple means, advanced disease may require a major surgical procedure to relieve scar tissue stricture of the esophagus which may eventuate and permanently disturb the swallowing mechanism. Hiatal hernia causing displacement of the cardioesophageal junction, the most common cause of esophagitis, can be corrected either by transabdominal or transthoracic surgical procedures directed toward reduction of the hernia. Fixation of the stomach to the abdominal wall in a position of downward traction has been used as a simple and successful means of correcting the hernia.