Fact-sheet: Hiatal hernia
Updated on 06/29/2020 at 11:12 AM
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Definition
More or less permanent protrusion of part of the stomach into the thorax through the esophageal hiatus.
3 types of hernia: sliding, paraesophageal (rolling), or mixed.
Clinical features
Acid gastroesophageal reflux, compression of thoracic organs (cardiorespiratory disturbances), mucosal complications (gastritis, cardial ulcer).
Radiography
Disappearance of the gastric air bubble and the presence of a left paracardiac mass on frontal view and a retrocardiac mass on lateral view.
CT
CT shows a retrocardiac mass and allows assessment of the diaphragmatic crura and their separation: in sliding hiatal hernia, the crura are separated by the gastric air bubble (hiatus > 10 mm), whereas in paraesophageal (rolling) hernia, the fundus lies above the hiatal orifice, which is of normal size.
Management
Surgical treatment if complications arise