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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.
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. [2]
Hiatal hernia [14] Cardiac bridge (Coronary occluding reflexes triggered by coronary reflexes) Enteric disease; Aneructonia, the loss of the ability to belch (continuous or intermittent) [citation needed] Bowel obstruction (Less common, this usually leads to intense pain in short time) Acute pancreatic necrosis [15] Eosinophilia
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 ...
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.
The classic symptoms of GERD were first described in 1925, when Friedenwald and Feldman commented on heartburn and its possible relationship to a hiatal hernia. [14] In 1934 gastroenterologist Asher Winkelstein described reflux and attributed the symptoms to stomach acid. [15]
A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure ...