The diagnosis and management of hiatus hernia

  title={The diagnosis and management of hiatus hernia},
  author={Sabine Roman and Peter J. Kahrilas},
  journal={BMJ : British Medical Journal},
#### Summary points Hiatus hernia is a condition involving herniation of the contents of the abdominal cavity, most commonly the stomach, through the diaphragm into the mediastinum. [] Key Method#### Sources and selection criteria We based this review on articles identified through a search of PubMed using the term “hiatal hernia” on 12 August 2014.

The management of hiatal hernia: an update on diagnosis and treatment

This narrative review presents new data on the diagnosis and management of hiatal hernia, and presents the imaging methods used for its diagnosis, as well as the medical and surgical treatment currently available.

Hiatal Hernia as the Cause of G-Induced Abdominal Pain.

An F-18 pilot who experienced worsening epigastric abdominal pain proportionate to the amount of accelerative force experienced, he was found to have a sliding hiatal hernia and underwent a Nissen fundoplication to repair it.

Chest Pain: A Relatively Benign Symptom of Type IV Hiatal Hernia

An 81-year-old female with a past medical history of gastroesophageal reflux disease, deep venous thrombosis, hypertension, hyperlipidemia, coronary artery disease, and cerebrovascular accident is treated conservatively with proton pump inhibitor (PPI) therapy for hiatal hernia.

Is fundoplication advisable in repair of para-oesophageal hernia? “Little operation” or “big operation”?

The case for routine fundoplication when repairing hiatus hernia, unless otherwise contraindicated, is supported, due to the configuration of para-oesophageal hiatus hernias and a diminution of reflux symptoms as the hernia progresses.

Utility of endoscopy in the diagnosis of hiatus hernia and correlation with GERD

The clinical features of hiatal hernias, its relationship with reflux disease, and the use of endoscopy in diagnosing hiatals as well as postoperative complications following foregut surgery are described.

Laparoscopic Hiatal Hernia Repair with or without Fundoplication. Is There Any Difference?

Laparoscopic hiatal hernia repair with Nissen Fundoplication had better short-term outcome than without NISSen fundoplication and there was not a statistically significance difference between the two studied groups regarding success rate.

Esophageal hiatal hernia: risk, diagnosis and management

This review summarizes updated evidence of pathophysiology, risk factors, diagnosis and management of hiatal hernias and indicates esophagectomy has chances of post-operative morbidity, while minimally invasive laparoscopy entails fewer postoperative difficulties and better visualization of hernia and related vascular damages.

Minimally invasive surgery: hiatal hernia repair—a narrative review

Expert opinion suggests that fundoplication should accompany crural repair in order to optimize reflux-related outcomes and to decrease recurrence risk, though there remains a need for further research into this topic.

Scoliosis and spina bifida contributing to strangulation of a hiatus hernia: a case report

A 67-year-old male patient with spina bifida and severe scoliosis who presented with an obstructed hiatus hernia is discussed here, highlighting the importance of providing definitive management to patients with difficult anatomy, which has caused their obstruction.

Classification and Evaluation of Diaphragmatic Hernias

Through a discussion of the anatomy of the diaphragm and the esophageal hiatus, the pathophysiology of these hernias is more easily understood and a fundamental guide for their classification and evaluation is provided.



Relationship of overweight to hiatus hernia and reflux oesophagitis.

The results support the view that adiposity is associated with both sliding pause hernia and reflux oesophagitis and that hiatus hernia plays a role in the development of refluxOesophageal reflux.

Association of obesity with hiatal hernia and esophagitis

Excessive body weight is a significant independent risk factor for hiatal hernia and is significantly associated with esophagitis, largely through an increased incidence of hiatAL hernia.

The Impact of Scoliosis Among Patients with Giant Paraesophageal Hernia

Kyphoscoliosis may contribute to the development and progression of paraesophageal hernias and surgeons approaching paraesophileal hernia repair should be aware of the increased pulmonary morbidity and the postoperative care required in managing patients.

Risk factors in the aetiology of hiatus hernia: a meta-analysis

The prevalence of HH increases with age and increasing BMI and HH is more common among men, and no significant evidence of publication bias was noted.

Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease

OBJECTIVE:Although reflux esophagitis is a multifactorial disease, the relative importance of these pathogenetic factors has not been clearly established. In this study, regression analysis was used

Guidelines for the management of hiatal hernia

The guidelines for the management of hiatal hernia are a series of systematically developed statements to assist physicians’ and patients’ decisions about the appropriate use of laparoscopic surgery

The effect of hiatus hernia on gastro-oesophageal junction pressure

Simulation of hernia reduction by algebraically summing the proximal segment pressures with the hiatal canal pressures restored normal maximal pressure, radial asymmetry, and dynamic responses of the gastro-oesophageal junction.

Inpatient Mortality Analysis of Paraesophageal Hernia Repair in Octogenarians

Non-elective repair was associated with a six to sevenfold increase in mortality and longer length of stay, and earlier elective repair of paraesophageal hernia may reduce mortality.