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A hiatal hernia or hiatus hernia [2] is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. [1] [3] This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn.
Endoscopic findings may include a hiatal hernia, esophagitis, strictures, tumors, or masses. [2] Increased pressure at the LES over time may result in an epiphrenic diverticulum. [ 2 ] Further evaluation for mechanical causes of obstruction may include CT scans, MRI, or endoscopic ultrasound.
This is complemented by gastro-coronary reflexes [12] whereby the coronary arteries constrict with "functional cardiovascular symptoms" similar to chest-pain on the left side and radiation to the left shoulder, dyspnea, sweating, up to angina pectoris-like attacks with extrasystoles, drop of blood pressure, and tachycardia (high heart rate) or ...
The diaphragm separates the chest from the abdomen. The esophagus (swallowing tube) passes through the hiatal opening in the diaphragm to reach the stomach. With a hiatal hernia, part of the stomach is displaced upwards into the chest (Figure 1). Large hiatal hernias may cause chronic gastrointestinal blood loss leading to iron deficiency anemia.
Hiatus hernia: A hiatal hernia occurs when a portion of the stomach pushes upward through the diaphragm into the chest cavity. While gastroesophageal reflux, presenting as heartburn and regurgitation, is the hallmark symptom, other manifestations such as dysphagia, epigastric or chest pain, and chronic iron deficiency anemia may also occur.
Hiatus, or hiatal hernias often result in heartburn but may also cause chest pain or pain while eating. [3] Risk factors for the development of a hernia include smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease and previous open appendectomy, among others.
Less common symptoms include pain with swallowing/sore throat, increased salivation (also known as water brash), nausea, [17] chest pain, coughing, and globus sensation. [18] The acid reflux can induce asthma attack symptoms like shortness of breath, cough, and wheezing in those with underlying asthma.
A laparoscopic hernia repair is when the hiatal hernia is corrected using a covering for the mesh that is used to repair the weakened area. The defect is then measured and the mesh is stapled into place. [6] A benefit of performing Laparoscopic hernia repair is shorter recovery times compared to other methods.