Materiały źródłowe

• #1 Hiatal Hernia: What It Is, Symptoms, Treatment & Surgery

  https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia

  A hiatal hernia happens when the top of your stomach bulges through an opening in your diaphragm. […] Treatment is available for hiatal hernias that cause symptoms. […] Healthcare providers find hiatal hernias by looking at images of your esophagus and stomach. […] If theyre looking for it, its usually because you have symptoms of acid reflux. […] Tests that can diagnose a hiatal hernia include: Chest X-ray, Esophagram, Upper endoscopy, Esophageal manometry. […] Hernias dont go away. They usually get worse over time. […] If your hiatal hernia never causes any symptoms, you might not need to treat it. […] Healthcare providers recommend hernia repair surgery when: Your hernia causes symptoms or complications that medications cant prevent. […] Hiatal hernia surgery has a 90% success rate.

• #1 Optimal workup for a hiatal hernia – Laracca – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5911/html

  Hiatal hernias are common and generally correlated with obesity and increasing age. However, many individuals have no symptoms and are never diagnosed, thus its hard to establish the real prevalence of hiatal hernias. To pursue a diagnosis of hiatal hernia is not necessary in asymptomatic patients, but symptomatic ones need evaluation and should be considered for surgical repair. The clinical workup is based on the patient’s symptomatology and clinical presentation. For elective HH repair we advocate the use of few standard pre-operative tests as first line. More specific functional and morphological studies scan should be used case by case depending on the hernia size, patients symptoms and setting. […] The optimal work up changes depending on patients history and clinical presentation.

• #1 How Do I Check Myself for a Hiatal Hernia? Signs, Getting Help

  https://www.healthline.com/health/how-do-i-check-myself-for-a-hiatal-hernia

  A hiatal hernia cannot be self-diagnosed with a physical exam and may be potentially dangerous. […] A doctor will perform several tests to make a diagnosis, such as a physical exam, imaging tests, or a barium swallow radiography test. […] Doctors may use different tests to check if you have a hiatal hernia, but its not possible to self-diagnose with a physical exam. […] Its not possible to self-diagnose a hiatal hernia. […] You may undergo different diagnostic tests for a doctor to confirm a diagnosis. These include: a physical exam, a barium swallow radiography test, an esophagogastroduodenoscopy (EGD), an esophageal manometry, a CT scan. […] X-rays, barium swallows, and CT scans can help healthcare professionals confirm the diagnosis.

• #1 Hiatal Hernia: Test and Diagnosis

  https://www.verywellhealth.com/diagnosing-hiatal-hernias-1742604

  Diagnosing a hiatal hernia involves imaging studies like X-rays, CT scans, and endoscopy. […] At other times, a hiatal hernia may be suspected in people with severe acid reflux who fail to respond to antacids or other treatments. […] For such cases, there are several tests healthcare providers can use to confirm the diagnosis. […] The preferred method of diagnosis of a hiatal hernia is an upper gastrointestinal (GI) barium study. […] A barium study is often enough to make a definitive diagnosis. When it’s unable to do so, a computed tomography (CT) scan may be ordered. […] A hiatal hernia can also be diagnosed with a procedure known as an upper GI endoscopy. […] Esophageal manometry can help your healthcare provider identify motor dysfunctions, such as dysphagia (difficulty swallowing), and how your hernia may contribute to them.

• #1 Hiatal Hernia Workup: Approach Considerations, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/178393-workup

  The typical reasons for evaluation are symptoms of GERD or a chest radiograph suggesting a paraesophageal hernia. […] A mass lesion in the central chest could be confused with a hiatal hernia. […] Although a chest radiograph may reveal a large hiatal hernia, and many incidentally diagnosed hiatal hernias are discovered in this manner, a barium study of the esophagus helps establish the diagnosis with greater accuracy. […] Typical findings include an outpouching of barium at the lower end of the esophagus, a wide hiatus through which gastric folds are seen in continuum with those in the stomach, and, occasionally, free reflux of barium. […] A barium study helps distinguish a sliding from a paraesophageal hernia. […] Hiatal hernia is diagnosed easily using upper gastrointestinal endoscopy.

• #1 Hiatus Hernia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hiatus-hernia-pro

  Diagnosing hiatus hernia (investigations) Hiatus hernias are often intermittent, so investigation may be unreliable. Investigation is needed to rule out sinister causes of symptoms and to exclude complications. The standard investigations are now endoscopy with or without manometry, although a hiatus hernia may be seen on chest X-ray or commonly incidentally on CT. […] CXR. Hiatus hernias may be seen on plain X-rays as a soft tissue opacity with or without an air-fluid level. A retrocardiac air-fluid level on CXR is diagnostic of a para-oesophageal hiatus hernia. […] Barium studies may still be used for diagnosis of hiatus hernia but not for mucosal complications. […] Endoscopy. […] Oesophageal manometry (mostly used when surgery is being considered).

• #1 Hiatal Hernia Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/369510-overview

  Hiatal hernia (also called hiatus hernia and paraesophageal hernia) occurs when part of the stomach protrudes into the thoracic cavity through the esophageal hiatus of the diaphragm. […] Most hiatal hernias are found incidentally, and they are usually discovered on routine chest radiographs or computed tomography (CT) scans performed for unrelated symptoms. […] An upper GI barium series is the preferred examination in the investigation of suggested hiatal hernia and its sequelae. […] CT scanning is not routinely used in the diagnosis of a hiatal hernia, but it may be useful for specific indications. […] Ultrasonography is a noninvasive technique that may be useful in the diagnosis of a hiatal hernia and gastroesophageal reflux. […] A small sliding hiatal hernia may be missed by using a barium swallow or meal study.

• #1 Hiatus hernia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/735

  Hiatus hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anaemia or haematemesis, or a combination of these. […] An upper gastrointestinal fluoroscopy with oral contrast is the key investigation technique and aids the surgeon in characterising any anatomical variation necessary for preoperative evaluation. Computed tomography scanning with 3-dimensional reconstruction can be helpful if the diagnosis is unclear, or when planning surgery. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomical configuration of the hernia. […] Uncomplicated sliding hiatus hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatus hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair.

• #1 Optimal workup for a hiatal hernia – Laracca – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5911/html

  Elective patients suspected for Hiatal Hernia are primarily examined for history of previous surgery, especially upper GI surgery, and comorbidities. Then a thorough analysis of signs and symptoms is mandatory. […] All patients with suspected or confirmed symptomatic hiatal hernia should undergo an esophagogastroduodenoscopy (EGD); however, given the diffusion of endoscopy, hiatal hernias are frequently diagnosed when endoscopy has been already performed for other symptoms and/or reasons. Endoscopy helps defining the anatomy, the size and type of the hernia, any associated esophageal and gastric mucosal disease such as esophagitis, Barretts esophagus and cancer. […] A hiatal hernia is diagnosed by EGD evaluating the distance between the EGJ and the diaphragmatic incisura, which is the impression of the diaphragmatic hiatus on the gastric wall. The endoscopic hiatal hernia diagnosis is defined as a distance greater than 2 cm.

• #1 Hiatal Hernia | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hiatal-hernia.html

  Esophageal manometry. This test checks the strength of your esophagus muscles. It can see if you have any problems with reflux or swallowing. A small tube is put into your nostril, then down your throat into your esophagus. This measures the pressure that your esophagus muscles make at rest and during swallowing.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6853045/

  Barium swallow radiography gives valuable information about the size of the herniated stomach and the location of the gastroesophageal junction. Most studies agree that barium swallow still remains essential in the diagnosis of hiatal hernia. […] Esophageal manometry provides valuable information regarding the motility of the esophagus. It is considered that a separation between the crural diaphragm and lower esophageal sphincter of 2 cm or more is diagnostic for hiatal hernia. […] The current guideline for the surgical treatment of hiatal hernia was elaborated by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in the year 2013. Through our literature research we have found that indications for surgery remain the same: symptomatic patients with paraesophageal hernia, especially those with obstructive symptoms and gastric volvulus, which require urgent surgery. […] The SAGES Guidelines strongly recommend not repairing type I hiatal hernia in the absence of reflux disease and symptoms; this recommendation remains valid to this day, as sustained by several authors.

• #1 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?pn=vol&uid=284&vmd=Full

  In patients with hiatal hernia, high pressure zone is separated into two zones with the proximal corresponding to the LES and the distal to the diaphragmatic indentation. […] High resolution manometry with topographic plotting has opened the door to accurately and objectively detecting and diagnosing hiatal hernias 2 cm, which had not been possible neither through radiographic, endoscopic nor conventional manometric assessment.

• #1 Hiatal hernia – Wikipedia

  https://en.wikipedia.org/wiki/Hiatal_hernia

  A hiatal herniaorhiatus hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. […] The diagnosis may be confirmed with endoscopy or medical imaging. […] Endoscopy can analyse the esophageal internal surface for erosions, ulcers, and tumours. […] The diagnosis of a hiatal hernia is typically made through an upper GI series, endoscopy, high resolution manometry, esophageal pH monitoring, and computed tomography (CT). […] pH testings allows the quantitative analysis of acid reflux episodes. […] CT scan is useful in diagnosing complications of hiatal hernia such as gastric volvulus, perforation, pneumoperitoneum, and pneumomediastinum.

• #1 Hiatal Hernia: Symptoms, Causes, Diagnosis, and Treatment

  https://www.webmd.com/digestive-disorders/hiatal-hernia

  To diagnose a hiatal hernia, your doctor may do tests including: […] Barium swallow. You drink a liquid that shows up on an X-ray so your doctor can get a better look at your esophagus and stomach. […] Endoscopy. Your doctor puts a long, thin tube called an endoscope down your throat. A camera on the end shows the inside of your esophagus and stomach. […] Esophageal manometry (pressure study). A different kind of tube goes down your throat to check the pressure in your esophagus when you swallow. […] pH test. This measures the acid levels in your esophagus. […] If anemia is a concern, your doctor may take a blood sample to check your red blood cell count.

• #1 Paraesophageal (Hiatal) Hernia Diagnosis & Treatment | AHN

  https://www.ahn.org/services/esophageal/conditions/paraesophageal-hernia

  A 24-hour impedance catheter is used to measure the reflux of fluid and gauge its proximity to your voice box. This test is typically used for patients who are experiencing cough, respiratory or non-classical GERD symptoms. A small catheter is inserted through your nose and records data in receiver worn around your waist during while you conduct your regular daily activities.

• #1 Hiatal Hernia: Test and Diagnosis

  https://www.verywellhealth.com/diagnosing-hiatal-hernias-1742604

  Esophageal pH monitoring is a test used to record changes in the acidity of your esophagus over a period of time (as measured by the pH). […] Youll need a medical test to tell if you have a hiatal hernia. […] Once a hiatal hernia is diagnosed, it is classified by type, which can help direct treatment and/or be used to monitor any changes in your condition. […] Even if a hiatal hernia is confirmed, a differential diagnosis may be needed to exclude other causes, especially if the hernia is small and inconsistent with the severity of symptoms. […] While you might want to check yourself for hiatal hernia, imagine tests are almost always needed to make a diagnosis. […] A healthcare provider will classify the type, perform a differential diagnosis to exclude other causes, and then discuss a treatment option.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6853045/

  Hiatal hernia (HH) occurs quite frequently in the general population and is characterized by a wide range of non-specific symptoms, most of them related to gastroesophageal reflux disease. […] This narrative review presents new data on the diagnosis and management of hiatal hernia. While the diagnostic pathway has remained virtually unchanged, new data have come to light regarding the surgical treatment of hiatal hernia. We present the imaging methods used for its diagnosis, as well as the medical and surgical treatment currently available. […] According to the Society of American Gastrointestinal and Endoscopic Surgeons, only investigations that will have an impact on the clinical management of the patient should be performed. The diagnosis of hiatal hernia can be rather challenging at times due to the shift in the anatomy of the esophagogastric junction during deglutition, respiration and movement. A complete history and physical exam is mandatory, as they may reveal symptoms that were not previously apparent.

• #1 Esophageal Manometry: Understanding Hiatal Hernia Diagnosis – Dr. Adam S. Harris, M.D.

  https://surgeonadamharris.com/esophageal-manometry-hiatal-hernia-diagnosis/

  So youve been experiencing symptoms like heartburn, chest pain, and difficulty swallowing, and your doctor suspects you may have a hiatal hernia. […] In this article, well break it down for you and focus specifically on one of the diagnostic tests used esophageal manometry. […] By understanding how this test works, youll be better equipped to understand your diagnosis and explore possible treatment options. […] Esophageal manometry is a diagnostic procedure used to assess the functionality and motility of the esophagus and lower esophageal sphincter (LES). […] This information is essential in diagnosing hiatal hernias and other esophageal motility disorders. […] Your doctor may recommend this procedure in the following situations: […] Suspected hiatal hernia or abnormalities in esophageal motility.

• #1 Optimal workup for a hiatal hernia – Laracca – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5911/html

  In our institution whenever possible we study all the patients scheduled for a hiatal hernia repair with a high resolution manometry (HRM); this exam provides important details about the motility of the esophagus and the EGJ. […] HRM can help to tune the operative strategy since findings of severe dysmotility or pseudoachalasia may indicate a simple hiatal repair without fundoplication. […] In patients complaining of respiratory symptoms, particularly shortness of breath and dyspnea on exertion, pulmonary function testing (PFT) may offer important information and also provide risk assessment. […] In patients with emergency presentations of hiatal hernia may present the Borchardts triad of symptoms: severe epigastric pain, retching with inability to vomit and impossibility to position a nasogastric tube into the stomach. […] A CT scan may be useful for patients with suspected complications from a gastric volvulus; it allows to visualize the herniated organs within the chest cavity.

• #1 Approaches to the Diagnosis and Grading of Hiatal Hernia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2548324/

  Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the esophageal hiatus into the mediastinum. 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 esophagogastric junction precludes the reliable detection of more subtle disruption by endoscopy or radiography. Detecting lesser degrees of axial separation between the lower esophageal sphincter and crural diaphragm can only be reliably accomplished with high resolution manometry, a technique that permits real time localization of these esophagogastric junction components without swallow or distention related artifact. […] The major significance of type I hernias is in their association with reflux disease. They are also the most difficult to objectively define and, hence, the major focus of controversy in diagnosis.

• #1 Approaches to the Diagnosis and Grading of Hiatal Hernia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2548324/

  The natural history of a type II hernia is progressive enlargement so that the entire stomach eventually herniates, with the pylorus juxtaposed to the gastric cardia, forming an upside-down, intrathoracic stomach. […] The radiographic demonstration of a sliding hiatus hernia is usually done in the setting of a barium swallow examination. However, in order to demonstrate the relative positions of the EGJ and the diaphragmatic hiatus, the positions of these structures must be visible radiographically, which means the esophagus must be distended with consequent shortening and displacement of the EGJ as discussed above. […] In summary, largely because of the inherent subjectivity in the radiographic criteria for defining type I hiatal hernia, estimates of prevalence vary enormously, from 10% to 80% of the adult population in North America.

• #1 Hiatus hernia | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hiatus-hernia?lang=us

  Hiatus hernias (alternative plural: herniae) occur when there is herniation of abdominal contents through the esophageal hiatus of the diaphragm into the thoracic cavity. […] Many patients with hiatus hernia are asymptomatic, and it is an incidental finding. However, symptoms may include epigastric or chest pain, postprandial fullness, nausea and vomiting. […] Sometimes hiatus hernias are considered synonymous with gastro-esophageal reflux disease (GERD), but there is a poor correlation between the two conditions. […] In some institutions measurement of a hiatal surface area (HSA) has been proposed. […] Symptomatic hiatus hernias, especially types 2-4, should be managed surgically. […] On a frontal chest radiograph consider: retrocardiac lung abscess, retrocardiac empyema, epiphrenic esophageal (pulsion) diverticulum, phrenic ampulla, postoperative change: esophagectomy with gastric pull-up procedure. […] In the setting of trauma consider diaphragmatic rupture.

• #1 Approaches to the Diagnosis and Grading of Hiatal Hernia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2548324/

  In general, there has been little uniformity or rigor applied to the assessment of sliding hiatus hernia with endoscopy. […] High resolution manometry objectifies the assessment of sliding hiatus hernia. For the first time, it offers a means to complete the continuum from normal to overt sliding hernia by detecting intermediate grades of EGJ disruption.

• #1 Hiatal Hernia Workup: Approach Considerations, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/178393-workup

  The diagnosis of a hiatal hernia actually is incidental, and endoscopy is used to diagnose complications such as erosive esophagitis, ulcers in the hiatal hernia, Barrett esophagus, or tumor. […] A hiatal hernia is confirmed when the endoscope is about to enter the stomach or on retrograde view once inside the stomach. […] More recent studies with esophageal high-resolution manometry (HRM) appear to be more accurate for detecting hiatal hernias. In one study that evaluated the HRM recordings, endoscopy reports, and barium esophagograms of 90 patients, HRM had a 92% sensitivity and 95% specificity for identifying hiatal hernias compared with a 73% sensitivity each for endoscopy and radiography.

• #1 Hiatus Hernia diagnosis & treatment with Mr Veeramootoo

  https://frimleyugi.co.uk/upper-gi-conditions/hiatus-hernia/

  Esophageal manometry is a test that measures the pressure and contractions in your esophagus. This test can help to identify motility problems that may be contributing to symptoms of hiatus hernia, such as difficulty swallowing. […] The diagnostic tests used to diagnose hiatus hernia are moderately accurate. In one study, a combination of barium swallow and upper endoscopy was 85% accurate in diagnosing hiatus hernia. […] After being diagnosed with hiatus hernia, you will have the opportunity to discuss treatment options with Mr Veeramootoo. Treatment options will depend on the severity of your symptoms and response to treatment. […] The long-term effects of hiatus hernia can vary depending on the severity of the condition and response to treatment. With proper management, most people with hiatus hernia can live long and healthy lives.

• #1 The diagnosis and management of hiatus hernia | The BMJ

  https://www.bmj.com/content/349/bmj.g6154

  Hiatus hernia refers to herniation of the contents of the abdominal cavity, most commonly the stomach, through the esophageal hiatus of the diaphragm into the mediastinum. […] In the absence of symptoms, there is no indication to diagnose or treat hiatus hernia. […] Endoscopy, radiology with barium swallow, or high resolution manometry can detect most cases of hiatus hernia. […] This clinical review summarises the current evidence for the diagnosis and management of hiatus hernia.

• #1 Hiatal Hernia | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hiatal-hernia.html

  Your healthcare provider will give you a physical exam. They will look at your past health. […] You may also have tests, including: […] Chest X-ray. This may show that you have a hiatal hernia. […] Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at the lining of your food pipe (esophagus), stomach, and the first part of your small intestine (the duodenum). It uses a thin, lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat while you are sedated. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. […] Upper GI (gastrointestinal) series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe (esophagus), stomach, and the first part of your small intestine (the duodenum). You will swallow a metallic fluid called barium. Barium coats the inside of the esophagus, stomach, and intestines so that they can be seen on an X-ray.

• #1 How to Diagnose Hiatus Hernia: Tests and Procedures

  https://www.darwynhealth.com/digestive-disorders/digestive-disorders/esophageal-and-swallowing-disorders/hiatus-hernia/how-to-diagnose-hiatus-hernia-tests-and-procedures/?lang=en

  Hiatus hernia is a medical condition that occurs when a portion of the stomach protrudes through the diaphragm into the chest cavity. […] To diagnose hiatus hernia, several tests are available that can provide valuable information about the condition. These tests include endoscopy, barium swallow, and esophageal manometry. […] Endoscopy is a common procedure used to visualize the esophagus and stomach. […] Another test commonly used to diagnose hiatus hernia is a barium swallow. […] Esophageal manometry is a test that measures the pressure and movement of the esophagus. […] These diagnostic tests, along with a thorough medical history and physical examination, can help healthcare professionals accurately diagnose hiatus hernia. […] Early diagnosis of hiatus hernia is crucial for several reasons.

• #2 Hiatal Hernia Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/369510-overview

  Hiatal hernia (also called hiatus hernia and paraesophageal hernia) occurs when part of the stomach protrudes into the thoracic cavity through the esophageal hiatus of the diaphragm. […] Most hiatal hernias are found incidentally, and they are usually discovered on routine chest radiographs or computed tomography (CT) scans performed for unrelated symptoms. […] An upper GI barium series is the preferred examination in the investigation of suggested hiatal hernia and its sequelae. […] CT scanning is not routinely used in the diagnosis of a hiatal hernia, but it may be useful for specific indications. […] Ultrasonography is a noninvasive technique that may be useful in the diagnosis of a hiatal hernia and gastroesophageal reflux. […] A small sliding hiatal hernia may be missed by using a barium swallow or meal study.

• #2 Optimal workup for a hiatal hernia – Laracca – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5911/html

  Elective patients suspected for Hiatal Hernia are primarily examined for history of previous surgery, especially upper GI surgery, and comorbidities. Then a thorough analysis of signs and symptoms is mandatory. […] All patients with suspected or confirmed symptomatic hiatal hernia should undergo an esophagogastroduodenoscopy (EGD); however, given the diffusion of endoscopy, hiatal hernias are frequently diagnosed when endoscopy has been already performed for other symptoms and/or reasons. Endoscopy helps defining the anatomy, the size and type of the hernia, any associated esophageal and gastric mucosal disease such as esophagitis, Barretts esophagus and cancer. […] A hiatal hernia is diagnosed by EGD evaluating the distance between the EGJ and the diaphragmatic incisura, which is the impression of the diaphragmatic hiatus on the gastric wall. The endoscopic hiatal hernia diagnosis is defined as a distance greater than 2 cm.

• #2

  https://www.aurorahealthcare.org/services/gastroenterology-colorectal-surgery/hiatus-hernia-hiatal-hernia

  A hiatal hernia is a problem with the muscles at the top of your stomach that keep it working properly. Your Aurora Health Care specialist will diagnose your condition and help you manage any symptoms. […] To diagnose a hiatal hernia, your doctor will perform a physical exam. They’ll talk to you about your medical history and possible symptoms of hiatal hernia. […] Consultation with a pulmonologist may be needed to help rule out other chest and lung conditions. Tests may be performed, including: Upper GI endoscopy: A flexible tube equipped with a light and tiny camera (endoscope) is inserted down your throat to see inside the esophagus and stomach. […] pH monitoring: This test checks for stomach acid in your esophagus. […] Motility testing (esophageal manometry): This test measures if the esophagus is working properly. […] Barium swallow: You’ll drink a liquid that contains barium (a silver-white metallic compound). The barium coats your esophagus and stomach and will show up on fluoroscopic X-rays taken at rest and while you swallow.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6853045/

  Barium swallow radiography gives valuable information about the size of the herniated stomach and the location of the gastroesophageal junction. Most studies agree that barium swallow still remains essential in the diagnosis of hiatal hernia. […] Esophageal manometry provides valuable information regarding the motility of the esophagus. It is considered that a separation between the crural diaphragm and lower esophageal sphincter of 2 cm or more is diagnostic for hiatal hernia. […] The current guideline for the surgical treatment of hiatal hernia was elaborated by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in the year 2013. Through our literature research we have found that indications for surgery remain the same: symptomatic patients with paraesophageal hernia, especially those with obstructive symptoms and gastric volvulus, which require urgent surgery. […] The SAGES Guidelines strongly recommend not repairing type I hiatal hernia in the absence of reflux disease and symptoms; this recommendation remains valid to this day, as sustained by several authors.

• #2 Hiatal hernia – Wikipedia

  https://en.wikipedia.org/wiki/Hiatal_hernia

  A hiatal herniaorhiatus hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. […] The diagnosis may be confirmed with endoscopy or medical imaging. […] Endoscopy can analyse the esophageal internal surface for erosions, ulcers, and tumours. […] The diagnosis of a hiatal hernia is typically made through an upper GI series, endoscopy, high resolution manometry, esophageal pH monitoring, and computed tomography (CT). […] pH testings allows the quantitative analysis of acid reflux episodes. […] CT scan is useful in diagnosing complications of hiatal hernia such as gastric volvulus, perforation, pneumoperitoneum, and pneumomediastinum.

• #2 Hiatal Hernia | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hiatal-hernia.html

  Your healthcare provider will give you a physical exam. They will look at your past health. […] You may also have tests, including: […] Chest X-ray. This may show that you have a hiatal hernia. […] Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at the lining of your food pipe (esophagus), stomach, and the first part of your small intestine (the duodenum). It uses a thin, lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat while you are sedated. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. […] Upper GI (gastrointestinal) series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe (esophagus), stomach, and the first part of your small intestine (the duodenum). You will swallow a metallic fluid called barium. Barium coats the inside of the esophagus, stomach, and intestines so that they can be seen on an X-ray.

• #2 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?pn=vol&uid=284&vmd=Full

  The relationship between hiatal hernias and gastroesophageal reflux disease (GERD) has been greatly debated over the past decades, with the importance of hiatal hernias first being overemphasized and then later being nearly neglected. […] Hiatal hernias can be diagnosed radiographically, endoscopically or manometrically, with each modality having its own limitations, especially in the diagnosis of hiatal hernias less than 2 cm in length. […] The diagnosis of hiatal hernia can be made through radiographic, endoscopic, and manometric assessment. Whereas large hiatal hernias can be detected and diagnosed without difficulty using either of these methods, diagnosing small hiatal hernias (2 cm) can be challenging with each modality having its limitations. […] The most commonly accepted diagnostic criterion of endoscopic hiatal hernia is the proximal dislocation of GEJ of 2 cm above the diaphragmatic indentation.

• #2 Optimal workup for a hiatal hernia – Laracca – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5911/html

  In our institution whenever possible we study all the patients scheduled for a hiatal hernia repair with a high resolution manometry (HRM); this exam provides important details about the motility of the esophagus and the EGJ. […] HRM can help to tune the operative strategy since findings of severe dysmotility or pseudoachalasia may indicate a simple hiatal repair without fundoplication. […] In patients complaining of respiratory symptoms, particularly shortness of breath and dyspnea on exertion, pulmonary function testing (PFT) may offer important information and also provide risk assessment. […] In patients with emergency presentations of hiatal hernia may present the Borchardts triad of symptoms: severe epigastric pain, retching with inability to vomit and impossibility to position a nasogastric tube into the stomach. […] A CT scan may be useful for patients with suspected complications from a gastric volvulus; it allows to visualize the herniated organs within the chest cavity.

• #2 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?pn=vol&uid=284&vmd=Full

  In patients with hiatal hernia, high pressure zone is separated into two zones with the proximal corresponding to the LES and the distal to the diaphragmatic indentation. […] High resolution manometry with topographic plotting has opened the door to accurately and objectively detecting and diagnosing hiatal hernias 2 cm, which had not been possible neither through radiographic, endoscopic nor conventional manometric assessment.

• #2 Hiatal Hernia Diagnosis: A Hernia doctor explains

  https://www.clinicahealth.in/hiatal-hernia-diagnosis-a-hernia-doctor-explains/

  Because most Hiatal hernias do not cause symptoms, they are usually discovered during a routine chest X-ray for an unrelated condition. A hiatal hernia may also be suspected in people with severe acid reflux who do not respond to antacids or other treatments. In such cases, healthcare providers can use a variety of tests to confirm the diagnosis, including X-rays and endoscopy. […] An upper gastrointestinal (GI) barium study is the preferred method of diagnosing a hiatal hernia. […] An upper GI endoscopy can also be used to diagnose a hiatal hernia. […] Esophageal manometry is a newer technology that assesses how the esophageal muscles and esophageal sphincter (valve) function; it is a possible diagnostic test, but it is not commonly used. […] Acid reflux is common in people who have a hiatal hernia. […] Even if a hiatal hernia is confirmed, a differential diagnosis may be required to rule out other possibilities, mainly if the hernia is small and inconsistent with the severity of symptoms.

• #2 Hiatal Hernia Workup: Approach Considerations, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/178393-workup

  The typical reasons for evaluation are symptoms of GERD or a chest radiograph suggesting a paraesophageal hernia. […] A mass lesion in the central chest could be confused with a hiatal hernia. […] Although a chest radiograph may reveal a large hiatal hernia, and many incidentally diagnosed hiatal hernias are discovered in this manner, a barium study of the esophagus helps establish the diagnosis with greater accuracy. […] Typical findings include an outpouching of barium at the lower end of the esophagus, a wide hiatus through which gastric folds are seen in continuum with those in the stomach, and, occasionally, free reflux of barium. […] A barium study helps distinguish a sliding from a paraesophageal hernia. […] Hiatal hernia is diagnosed easily using upper gastrointestinal endoscopy.

• #2 Approaches to the Diagnosis and Grading of Hiatal Hernia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2548324/

  The natural history of a type II hernia is progressive enlargement so that the entire stomach eventually herniates, with the pylorus juxtaposed to the gastric cardia, forming an upside-down, intrathoracic stomach. […] The radiographic demonstration of a sliding hiatus hernia is usually done in the setting of a barium swallow examination. However, in order to demonstrate the relative positions of the EGJ and the diaphragmatic hiatus, the positions of these structures must be visible radiographically, which means the esophagus must be distended with consequent shortening and displacement of the EGJ as discussed above. […] In summary, largely because of the inherent subjectivity in the radiographic criteria for defining type I hiatal hernia, estimates of prevalence vary enormously, from 10% to 80% of the adult population in North America.

• #2 The diagnosis and management of hiatus hernia | The BMJ

  https://www.bmj.com/content/349/bmj.g6154

  Hiatus hernia refers to herniation of the contents of the abdominal cavity, most commonly the stomach, through the esophageal hiatus of the diaphragm into the mediastinum. […] In the absence of symptoms, there is no indication to diagnose or treat hiatus hernia. […] Endoscopy, radiology with barium swallow, or high resolution manometry can detect most cases of hiatus hernia. […] This clinical review summarises the current evidence for the diagnosis and management of hiatus hernia.

• #2 Hiatal Hernia | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hiatal-hernia.html

  Esophageal manometry. This test checks the strength of your esophagus muscles. It can see if you have any problems with reflux or swallowing. A small tube is put into your nostril, then down your throat into your esophagus. This measures the pressure that your esophagus muscles make at rest and during swallowing.

• #2 How to Diagnose Hiatus Hernia: Tests and Procedures

  https://www.darwynhealth.com/digestive-disorders/digestive-disorders/esophageal-and-swallowing-disorders/hiatus-hernia/how-to-diagnose-hiatus-hernia-tests-and-procedures/?lang=en

  Seeking early medical attention for hiatus hernia symptoms is essential to prevent these complications. […] By diagnosing hiatus hernia early, healthcare professionals can recommend appropriate treatment options to manage symptoms, reduce acid reflux, and prevent further damage to the esophagus. […] In some cases, surgical intervention may be necessary to repair the hernia and strengthen the LES. […] If you experience symptoms such as heartburn, chest pain, or difficulty swallowing, it is important to consult with a healthcare professional for a proper evaluation and diagnosis. […] The common diagnostic tests for hiatus hernia include: – Upper gastrointestinal (GI) endoscopy: This procedure involves inserting a thin, flexible tube with a camera into your throat to examine the esophagus and stomach. – Barium swallow: You will be asked to drink a liquid containing barium, which helps visualize the esophagus and stomach on X-rays. – Esophageal manometry: This test measures the pressure and movement of the esophagus to assess its function.

• #2 Hiatal Hernia: What It Is, Symptoms, Treatment & Surgery

  https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia

  Most people are able to discontinue medications and enjoy life free of acid reflux after hiatal hernia surgery. […] You may discover a hiatal hernia incidentally while visiting a healthcare provider for another reason. […] Alternatively, you may discover a hiatal hernia after years of worsening symptoms finally bringing you to seek answers and relief. […] Fortunately, both acid reflux and hiatal hernias are treatable.

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