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A 16-year old girl with cerebral palsy had a fundoplication and gastrostomy at birth. She developed a hiatal hernia and disruption of the fundoplication two years ago and underwent revision fundoplication with primary hiatal hernia repair. She now presents with recurrent reflux symptoms and recent hospitalization for aspiration pneumonia. Her most recent upper gastrointestinal series through her gastrostomy is shown. She continues to take feedings by mouth.
The most definitive management of this hiatal hernia would be primary
A posterior crural repair.
B anterior crural repair.
C anterior and posterior crural repair.
D repair and placement of biologic mesh.
E repair and placement of prolene mesh.
A 16-year old girl with cerebral palsy had a fundoplication and gastrostomy at birth. She developed a hiatal hernia and disruption of the fundoplication two years ago and underwent revision fundoplication with primary hiatal hernia repair. She now presents with recurrent reflux symptoms and recent hospitalization for aspiration pneumonia. Her most recent upper gastrointestinal series through her gastrostomy is shown. She continues to take feedings by mouth.
The most definitive management of this hiatal hernia would be primary
A posterior crural repair.
B anterior crural repair.
C anterior and posterior crural repair.
D repair and placement of biologic mesh.
E repair and placement of prolene mesh.
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