Hiatus hernia other imaging findings: Difference between revisions
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* In paraesophageal hernia upper endoscopy demonostartes herniation of a portion of the stomach upward through the diaphragm adjacent to the endoscope. | * In paraesophageal hernia upper endoscopy demonostartes herniation of a portion of the stomach upward through the diaphragm adjacent to the endoscope. | ||
== High resolution manometry == | |||
* High resolution manometry with esophageal pressure topography (EPT) may be helpful in the diagnosis of hiatus hernia. Findings on an High resolution manometry suggestive of hiatus hernia include:<ref name="pmid186568193">{{cite journal |vauthors=Kahrilas PJ, Kim HC, Pandolfino JE |title=Approaches to the diagnosis and grading of hiatal hernia |journal=Best Pract Res Clin Gastroenterol |volume=22 |issue=4 |pages=601–16 |year=2008 |pmid=18656819 |pmc=2548324 |doi=10.1016/j.bpg.2007.12.007 |url=}}</ref> | |||
** Separation of the crural diaphragm from the lower esophageal sphincter (LES) by a pressure trough. | |||
** Enables the identification of intermittent herniation. | |||
** Identify a sliding hiatus hernia as it permits real-time localization of the esophagogastric junction | |||
==References== | ==References== |
Revision as of 20:38, 6 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
A hiatal hernia occurs when a part of the stomach protrudes into the thoracic cavity through the esophageal hiatus of the diaphragm. Approximately 99% of hiatal hernias are sliding, and the rest 1% are paraesophageal hernia.Barium swallow may be helpful in the diagnosis of a hiatus hernia. Findings on a Barium swallow suggestive hiatus hernia include anatomy and size of a hernia, the orientation of the stomach location of the Gastroesophageal junction.
Barium swallow
- .Barium swallow may be helpful in the diagnosis of a hiatal hernia. Findings on an barium swallow suggestive of hiatus hernia include:[1] [2] [3]
- Anatomy of a hernia
- Size of a hernia
- Orientation of the stomach
- location of the gastroesophageal junction
- If a sliding hernia is suspected a greater than a 2-cm division between the mucosal B ring at the site of the squamocolumnar junction and the diaphragmatic hiatus is noticed.
- If B ring not identified on barium swallow, evident of at least 3 rugal folds is diagnostic of a sliding hiatus hernia.
- On barium swallow herniating of gastric fundus along the distal esophagus is diagnostic of a paraesophageal hernia.
Upper Endoscopy
- Upper Endoscopy may be helpful in the diagnosis of hiatus hernia. Findings on an Upper Endoscopy suggestive of hiatus hernia include:[4]
- Larger than 2-cm separation between the squamocolumnar junction and the diaphragm.
- In paraesophageal hernia upper endoscopy demonostartes herniation of a portion of the stomach upward through the diaphragm adjacent to the endoscope.
High resolution manometry
- High resolution manometry with esophageal pressure topography (EPT) may be helpful in the diagnosis of hiatus hernia. Findings on an High resolution manometry suggestive of hiatus hernia include:[5]
- Separation of the crural diaphragm from the lower esophageal sphincter (LES) by a pressure trough.
- Enables the identification of intermittent herniation.
- Identify a sliding hiatus hernia as it permits real-time localization of the esophagogastric junction
References
- ↑ Kahrilas PJ, Kim HC, Pandolfino JE (2008). "Approaches to the diagnosis and grading of hiatal hernia". Best Pract Res Clin Gastroenterol. 22 (4): 601–16. doi:10.1016/j.bpg.2007.12.007. PMC 2548324. PMID 18656819.
- ↑ Hyun JJ, Bak YT (2011). "Clinical significance of hiatal hernia". Gut Liver. 5 (3): 267–77. doi:10.5009/gnl.2011.5.3.267. PMC 3166665. PMID 21927653.
- ↑ Weitzendorfer M, Köhler G, Antoniou SA, Pallwein-Prettner L, Manzenreiter L, Schredl P, Emmanuel K, Koch OO (2017). "Preoperative diagnosis of hiatal hernia: barium swallow X-ray, high-resolution manometry, or endoscopy?". Eur Surg. 49 (5): 210–217. doi:10.1007/s10353-017-0492-y. PMC 5653726. PMID 29104588.
- ↑ Kahrilas PJ, Kim HC, Pandolfino JE (2008). "Approaches to the diagnosis and grading of hiatal hernia". Best Pract Res Clin Gastroenterol. 22 (4): 601–16. doi:10.1016/j.bpg.2007.12.007. PMC 2548324. PMID 18656819.
- ↑ Kahrilas PJ, Kim HC, Pandolfino JE (2008). "Approaches to the diagnosis and grading of hiatal hernia". Best Pract Res Clin Gastroenterol. 22 (4): 601–16. doi:10.1016/j.bpg.2007.12.007. PMC 2548324. PMID 18656819.