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Hiatal Hernia
Michael P. Federle, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Hiatal hernia (HH)
        • Definitions

          • Protrusion of part of stomach through esophageal hiatus of diaphragm

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Staging, Grading, & Classification

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                Selected References

                                1. D'Netto TJ et al: A technique for the laparoscopic repair of paraoesophageal hernia without mesh. J Gastrointest Surg. 18(4):851-7; discussion 857, 2014
                                2. Sheikh I et al: Consumer Use of Over-the-Counter Proton Pump Inhibitors in Patients With Gastroesophageal Reflux Disease. Am J Gastroenterol. 109(6):789-94, 2014
                                3. Dean C et al: Hiatal hernias. Surg Radiol Anat. 34(4):291-9, 2012
                                4. Nason KS et al: The laparoscopic approach to paraesophageal hernia repair. J Gastrointest Surg. 16(2):417-26, 2012
                                5. Belhocine K et al: Epidemiology of the complications of gastroesophageal reflux disease. Dig Dis. 27(1):7-13, 2009
                                6. Larusson HJ et al: Predictive factors for morbidity and mortality in patients undergoing laparoscopic paraesophageal hernia repair: age, ASA score and operation type influence morbidity. World J Surg. 33(5):980-5, 2009
                                7. Yano F et al: Outcomes of surgical treatment of intrathoracic stomach. Dis Esophagus. 22(3):284-8, 2009
                                8. Granderath FA et al: Laparoscopic revisional fundoplication with circular hiatal mesh prosthesis: the long-term results. World J Surg. 32(6):999-1007, 2008
                                9. Linke GR et al: Is a barium swallow complementary to endoscopy essential in the preoperative assessment of laparoscopic antireflux and hiatal hernia surgery? Surg Endosc. 22(1):96-100, 2008
                                10. Wykypiel H et al: Laparoscopic partial posterior (Toupet) fundoplication improves esophageal bolus propagation on scintigraphy. Surg Endosc. 22(8):1845-51, 2008
                                11. Huang SY et al: Large hiatal hernia with floppy fundus: clinical and radiographic findings. AJR Am J Roentgenol. 188(4):960-4, 2007
                                12. Rantanen TK et al: Gastroesophageal reflux disease as a cause of death is increasing: analysis of fatal cases after medical and surgical treatment. Am J Gastroenterol. 102(2):246-53, 2007
                                13. Zaninotto G et al: Long-term results (6-10 years) of laparoscopic fundoplication. J Gastrointest Surg. 11(9):1138-45, 2007
                                14. Canon CL et al: Surgical approach to gastroesophageal reflux disease: what the radiologist needs to know. Radiographics. 25(6):1485-99, 2005
                                15. Insko EK et al: Benign and malignant lesions of the stomach: evaluation of CT criteria for differentiation. Radiology. 228(1):166-71, 2003
                                16. Pierre AF et al: Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg. 74(6):1909-15; discussion 1915-6, 2002
                                17. Patti MG et al: Preoperative evaluation of patients with gastroesophageal reflux disease. J Laparoendosc Adv Surg Tech A. 11(6):327-31, 2001
                                18. Katkhouda N et al: Laparoscopic repair of chronic intrathoracic gastric volvulus. Surgery. 128(5):784-90, 2000
                                19. Luketich JD et al: Laparoscopic repair of giant paraesophageal hernia: 100 consecutive cases. Ann Surg. 232(4):608-18, 2000
                                20. Schauer PR et al: Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg. 176(6):659-65, 1998
                                21. Maglinte DD et al: Radiologic features of carcinomas arising in hiatal hernias. AJR Am J Roentgenol. 166(4):789-94, 1996
                                22. Weston AP: Hiatal hernia with cameron ulcers and erosions. Gastrointest Endosc Clin N Am. 6(4):671-9, 1996
                                23. Vas W et al: Computed tomographic evaluation of paraesophageal hernia. Gastrointest Radiol. 14(4):291-4, 1989
                                24. Chen YM et al: Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: evaluation of the individual techniques. Gastrointest Radiol. 10(4):311-6, 1985
                                25. Pupols A et al: Hiatal hernia causing a cardia pseudomass on computed tomography. J Comput Assist Tomogr. 8(4):699-700, 1984
                                26. Cassel DM et al: Hiatus hernia causing CT gastric mass lesions. Comput Radiol. 7(3):177-9, 1983
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Imaging

                                  • Top Differential Diagnoses

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Abbreviations

                                        • Hiatal hernia (HH)
                                      • Definitions

                                        • Protrusion of part of stomach through esophageal hiatus of diaphragm

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • CT Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • General Features

                                                  • Staging, Grading, & Classification

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Demographics

                                                        • Natural History & Prognosis

                                                          • Treatment

                                                            DIAGNOSTIC CHECKLIST

                                                            • Consider

                                                              Selected References

                                                              1. D'Netto TJ et al: A technique for the laparoscopic repair of paraoesophageal hernia without mesh. J Gastrointest Surg. 18(4):851-7; discussion 857, 2014
                                                              2. Sheikh I et al: Consumer Use of Over-the-Counter Proton Pump Inhibitors in Patients With Gastroesophageal Reflux Disease. Am J Gastroenterol. 109(6):789-94, 2014
                                                              3. Dean C et al: Hiatal hernias. Surg Radiol Anat. 34(4):291-9, 2012
                                                              4. Nason KS et al: The laparoscopic approach to paraesophageal hernia repair. J Gastrointest Surg. 16(2):417-26, 2012
                                                              5. Belhocine K et al: Epidemiology of the complications of gastroesophageal reflux disease. Dig Dis. 27(1):7-13, 2009
                                                              6. Larusson HJ et al: Predictive factors for morbidity and mortality in patients undergoing laparoscopic paraesophageal hernia repair: age, ASA score and operation type influence morbidity. World J Surg. 33(5):980-5, 2009
                                                              7. Yano F et al: Outcomes of surgical treatment of intrathoracic stomach. Dis Esophagus. 22(3):284-8, 2009
                                                              8. Granderath FA et al: Laparoscopic revisional fundoplication with circular hiatal mesh prosthesis: the long-term results. World J Surg. 32(6):999-1007, 2008
                                                              9. Linke GR et al: Is a barium swallow complementary to endoscopy essential in the preoperative assessment of laparoscopic antireflux and hiatal hernia surgery? Surg Endosc. 22(1):96-100, 2008
                                                              10. Wykypiel H et al: Laparoscopic partial posterior (Toupet) fundoplication improves esophageal bolus propagation on scintigraphy. Surg Endosc. 22(8):1845-51, 2008
                                                              11. Huang SY et al: Large hiatal hernia with floppy fundus: clinical and radiographic findings. AJR Am J Roentgenol. 188(4):960-4, 2007
                                                              12. Rantanen TK et al: Gastroesophageal reflux disease as a cause of death is increasing: analysis of fatal cases after medical and surgical treatment. Am J Gastroenterol. 102(2):246-53, 2007
                                                              13. Zaninotto G et al: Long-term results (6-10 years) of laparoscopic fundoplication. J Gastrointest Surg. 11(9):1138-45, 2007
                                                              14. Canon CL et al: Surgical approach to gastroesophageal reflux disease: what the radiologist needs to know. Radiographics. 25(6):1485-99, 2005
                                                              15. Insko EK et al: Benign and malignant lesions of the stomach: evaluation of CT criteria for differentiation. Radiology. 228(1):166-71, 2003
                                                              16. Pierre AF et al: Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg. 74(6):1909-15; discussion 1915-6, 2002
                                                              17. Patti MG et al: Preoperative evaluation of patients with gastroesophageal reflux disease. J Laparoendosc Adv Surg Tech A. 11(6):327-31, 2001
                                                              18. Katkhouda N et al: Laparoscopic repair of chronic intrathoracic gastric volvulus. Surgery. 128(5):784-90, 2000
                                                              19. Luketich JD et al: Laparoscopic repair of giant paraesophageal hernia: 100 consecutive cases. Ann Surg. 232(4):608-18, 2000
                                                              20. Schauer PR et al: Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg. 176(6):659-65, 1998
                                                              21. Maglinte DD et al: Radiologic features of carcinomas arising in hiatal hernias. AJR Am J Roentgenol. 166(4):789-94, 1996
                                                              22. Weston AP: Hiatal hernia with cameron ulcers and erosions. Gastrointest Endosc Clin N Am. 6(4):671-9, 1996
                                                              23. Vas W et al: Computed tomographic evaluation of paraesophageal hernia. Gastrointest Radiol. 14(4):291-4, 1989
                                                              24. Chen YM et al: Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: evaluation of the individual techniques. Gastrointest Radiol. 10(4):311-6, 1985
                                                              25. Pupols A et al: Hiatal hernia causing a cardia pseudomass on computed tomography. J Comput Assist Tomogr. 8(4):699-700, 1984
                                                              26. Cassel DM et al: Hiatus hernia causing CT gastric mass lesions. Comput Radiol. 7(3):177-9, 1983