Approaches to the diagnosis and grading of hiatal hernia

Peter J. Kahrilas*, Hyon C. Kim, John E. Pandolfino

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

188 Scopus citations

Abstract

Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum. With the most common type (type I or sliding hiatus hernia) this is associated with laxity of the phrenooesophageal membrane and the gastric cardia herniates. Sliding hiatus hernia is readily diagnosed by barium swallow radiography, endoscopy, or manometry when greater than 2 cm in axial span. However, the mobility of the oesophagogastric junction precludes the reliable detection of more subtle disruption by endoscopy or radiography. Detecting lesser degrees of axial separation between the lower oesophageal sphincter and crural diaphragm can only be reliably accomplished with high-resolution manometry, a technique that permits real time localization of these oesophagogastric junction components without swallow or distention related artefact.

Original languageEnglish (US)
Pages (from-to)601-616
Number of pages16
JournalBest Practice and Research: Clinical Gastroenterology
Volume22
Issue number4
DOIs
StatePublished - Aug 1 2008

Keywords

  • Hiatus hernia
  • endoscopy radiography
  • high-resolution manometry

ASJC Scopus subject areas

  • Gastroenterology

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