Benign surgical diseases of the gastro-oesophageal junction

Benign surgical conditions of the oesophago-gastric junction (OGJ) are important causes of morbidity and in some cases mortality for patients. This chapter discusses both elective and emergency benign disorders of the OGJ, their investigation and management. Elective conditions include gastro-oesophageal reflux disease (GORD), giant para-oesophageal hiatal herniae (GPHH), achalasia and other motility disorders. These conditions are now usually all managed laparoscopically when operative intervention is required. Emergency conditions include acute presentations of giant para-oesophageal hiatal herniae and OGJ perforations including Boerhaave's syndrome. These conditions present diagnostic and management challenges to the surgeon and are associated with significant morbidity and mortality. Varices, gastro-intestinal stromal tumours (GISTs), ulcers and bleeding are not discussed in this article.