Rare Hernia is No Match for Skilled Surgeon

Mary Frank, a 49-year-old substitute teacher from Baltimore, suffered from heartburn for years, frequently experiencing the burning sensation of acid reflux in her chest after eating. She learned that a hernia was the likely culprit behind her discomfort. Until recently, her symptoms were well-controlled with prescription medication and over-the-counter antacids when she needed extra relief.

One afternoon last summer, Ms. Frank’s symptoms took a frightening turn; she was having lunch at a restaurant and suddenly began having severe chest pain and shortness of breath. She called 911 and was taken by ambulance to the emergency room of a local hospital. “I had horrible pain in my chest that extended into my shoulders. I knew it had to be related to the hernia,” Ms. Frank notes, adding that this was the worst her symptoms had ever been.

Ms. Frank was admitted to the hospital, where a battery of tests revealed that her hernia was so advanced, it would require surgery to repair it. After being discharged, she was referred to Dr. Timothee Friesen, a general surgeon at GBMC’s Finney Trimble Surgical Associates office, in early October 2013.

“I loved Dr. Friesen right away,” she says. “He drew pictures to show me exactly what would happen during the surgery, explained everything and answered all of my questions.”

“Mary was suffering from the effects of a paraesophageal hernia” says Dr. Friesen. “This is the least common type of hernia. It occurs when the opening in the diaphragm through which the esophagus passes is larger than usual, allowing the stomach to push up into the esophagus. It’s dangerous because the stomach’s blood supply could get cut off, causing the tissue to die.” To fix the problem, the surgeon performs a laparoscopic procedure to wrap the herniated portion of the stomach around the esophagus, closing the hole.

Dr. Friesen states that hernias like Ms. Frank’s are rare. “It’s more likely for women to experience ventral or incisional hernias, which are caused by a weakened abdominal wall.” These hernias commonly show up as a bulging mass below the skin’s surface and can develop at the site of an incision from a previous surgery. Symptoms of hernias frequently include pain in the abdomen and acid reflux, but some go undetected.

“If acid reflux is a problem and it is not responding to medication after a year, consult with a physician. It could be a symptom of a more serious condition,” adds Dr. Friesen.

Following Ms. Frank’s surgery in December 2013, she was placed on a post-operative liquid diet for two weeks. After that, she was able to resume a normal diet with no problems. “Before the surgery, I was afraid to eat. Every day I had stomach pain, chest pains and difficulty breathing. Thanks to Dr. Friesen, all of the heartburn and reflux completely disappeared,” says Ms. Frank. “I couldn’t be happier with the results!”