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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.
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.
Diagnosis of Roemheld syndrome usually begins with a cardiac workup, as the gastric symptoms may go unnoticed, and the cardiac symptoms are frightening and can be quite severe. After an EKG , Holter monitor , tilt table test , cardiac MRI , cardiac CT , heart catheterization , electrophysiology study , echocardiogram , and extensive blood work ...
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.
Diaphragmatic hernia; This is a photo of a peritoneopericardial diaphragmatic hernia in a cat. The photo was taken during necropsy from the right side of the cat. To the left is the abdomen, where part of the liver and the gall bladder can be seen. The diaphragm is in the middle. To the right is the thorax.
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.
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