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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.
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 ...
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.
It can be caused by or associated with gastroesophageal reflux disease, [1] esophagitis, a dysfunctional lower esophageal sphincter, disordered motility, lye ingestion, or a hiatal hernia. Strictures can form after esophageal surgery and other treatments such as laser therapy or photodynamic therapy. While the area heals, a scar forms, causing ...
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, 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.
Psychogenic causes of chest pain can include panic attacks; however, this is a diagnosis of exclusion. [12] In children, the most common causes for chest pain are musculoskeletal (76–89%), exercise-induced asthma (4–12%), gastrointestinal illness (8%), and psychogenic causes (4%). [13] Chest pain in children can also have congenital causes.
About one third of the cases are associated with a hiatal hernia. Treatment is surgical. The classic triad (Borchardt's Triad) of gastric volvulus, described by Borchardt in 1904, consists of severe epigastric pain, retching (due to sour taste in mouth) without vomiting, and inability to pass a nasogastric tube. It reportedly occurs in 70% of ...
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