Hiatal Hernia Overview

Front

What is a hiatal hernia?

Back

A condition where the opening in the diaphragm through which the esophagus passes becomes enlarged, allowing part of the upper stomach to move into the lower thorax.

Front

What are the two main types of hiatal hernias?

Back

Sliding (type I) and paraesophageal hernias.

Front

What characterizes a sliding hiatal hernia?

Back

The upper stomach and gastroesophageal junction are displaced upward and slide in and out of the thorax.

Front

What percentage of patients with esophageal hiatal hernia have a sliding hernia?

Back

Between 90% and 95%.

Front

What is a paraesophageal hernia?

Back

A hernia where all or part of the stomach pushes through the diaphragm beside the esophagus.

Front

How are paraesophageal hernias classified?

Back

As types II, III, or IV, depending on the extent of herniation.

Front

What is the most severe type of paraesophageal hernia?

Back

Type IV, which has the greatest herniation and may include other intra-abdominal viscera.

Front

What are common clinical manifestations of a sliding hiatal hernia?

Back

Pyrosis, regurgitation, dysphagia, and sometimes vague symptoms like epigastric pain or fullness after eating.

Front

What complications can occur with any type of hernia?

Back

Hemorrhage, obstruction, volvulus, and strangulation.

Front

What diagnostic methods are used to confirm a hiatal hernia?

Back

X-ray studies, barium swallow, esophagogastroduodenoscopy (EGD), esophageal manometry, and chest CT scan.