DOI: http://dx.doi.org/10.18203/2349-2902.isj20210930

Study on incidence of hiatus hernia in patients undergoing upper gastrointestinal endoscopy for upper gastrointestinal symptoms in a secondary care hospital

Shashidhara Puttaraju, Sanhitha Purushotham

Abstract


Background: Hiatus hernia refers to condition in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum.Hiatal hernia is a frequent finding during upper gastrointestinal endoscopy. Type I hiatal hernia is the sliding hiatal hernia, which accounts for more than 95% of all hiatal hernias with the remaining 5% being paraesophageal hiatal hernias taken together. Surgical therapy is recommended for patients with severe and refractory GERD symptoms such as poor compliance to long-term medical therapy and young patients wishing to avoid lifetime medical treatment. The objective of this study was to identify the associated symptoms and to determine diagnostic accuracy of endoscopic evaluation in patients with hiatus hernia.

Methods: Current retrospective study comprised of 250 patients who presented with complaints of upper gastrointestinal symptoms and underwent upper gastrointestinal endoscopy in JSS hospital, Chamarajnagar during the period of October 2018 to May 2020.

Results: Out of 250 patients, 162 males (64.8%) and 88 females (35.2%) were part of the study, who presented with upper GI symptoms, 12 (4.8%) patients were diagnosed with hiatus hernia. Out of these 12 cases, 9 patients (75%) were found to be having sliding type of hiatus hernia and 3 patients (25%) having rolling type.

Conclusions: Early diagnosis and timely management or surgical intervention reduces morbidity associated with hiatus hernia and acid reflux. Hence, all patients presenting with persistent upper gastrointestinal symptoms should undergo upper GI endoscopy managed accordingly.


Keywords


Hiatus hernia, Upper gastrointestinal endoscopy, Upper gastrointestinal symptoms

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References


Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601-16.

Hyun JJ, Bak Y-T. Clinical significance of hiatal hernia. Gut Liver. 2011;5(3):267-77.

Ténaiová J, Tůma L, Hrubant K, Brůha R, Svestka T, Novotný A, et al. Incidence of hiatal hernias in the current endoscopic praxis. Cas Lek Cesk. 2007;146 (1):74-6.

Ugiagbe RA, Omuemu CE. Diagnostic indications for upper gastrointestinal endoscopy. Ann Biomed Sci. 2012;11(2):65-70.

Williams N, Bulstrode C, Connell P, Bailey H, Love R. Bailey & Love's short practice of surgery. 27th ed. United States: CRC Press; 221.

Marchand P. The anatomy of esophageal hiatus of the diaphragm and the pathogenesis of hiatus herniation. J Thorac Surg. 1959;37:81-92.

Lin S, Brasseur JG, Pouderoux P, Kahrilas PJ. The phrenic ampulla: distal esophagus or potential hiatal hernia? Am J Physiol. 1995;268:G320-7.

Bombeck CT, Dillard DH, Nyhus LM. Muscular anatomy of the gastroesophageal junction and role of phrenoesophageal ligament; autopsy study of sphincter mechanism. Ann Surg. 1966;164:643-54.

Wolf BS. Sliding hiatal hernia: the need for redefinition. Am J Roentgenol Radium Ther Nucl Med. 1973;117:231-47.

Friedland GW. Progress in radiology: historical review of the changing concepts of lower esophageal anatomy. Am J Roentgenol. 1978;131:373-8.

Mittal RK. Hiatal hernia: myth or reality?. Am J Med. 1997;103(5A):33-9.

Dodds WJ. 1976 Walter B. Cannon lecture: current concepts of esophageal motor function--clinical implications for radiology. AJR Am J Roentgenol. 1977;128:549-61.

Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601-16.

Hyun JJ, Bak Y-T. Clinical significance of hiatal hernia. Gut Liver. 2011;5(3):267-77.

Ténaiová J, Tůma L, Hrubant K, Brůha R, Svestka T, Novotný A, et al. Incidence of hiatal hernias in the current endoscopic praxis. Cas Lek Cesk. 2007;146 (1):74-6.

Ugiagbe RA, Omuemu CE. Diagnostic indications for upper gastrointestinal endoscopy. Ann Biomed Sci. 2012;11(2):65-70.

Williams N, Bulstrode C, Connell P, Bailey H, Love R. Bailey & Love's short practice of surgery. 27th ed. United States: CRC Press; 221.

Marchand P. The anatomy of esophageal hiatus of the diaphragm and the pathogenesis of hiatus herniation. J Thorac Surg. 1959;37:81-92.

Lin S, Brasseur JG, Pouderoux P, Kahrilas PJ. The phrenic ampulla: distal esophagus or potential hiatal hernia? Am J Physiol. 1995;268:G320-7.

Bombeck CT, Dillard DH, Nyhus LM. Muscular anatomy of the gastroesophageal junction and role of phrenoesophageal ligament; autopsy study of sphincter mechanism. Ann Surg. 1966;164:643-54.

Wolf BS. Sliding hiatal hernia: the need for redefinition. Am J Roentgenol Radium Ther Nucl Med. 1973;117:231-47.

Friedland GW. Progress in radiology: historical review of the changing concepts of lower esophageal anatomy. Am J Roentgenol. 1978;131:373-8.

Mittal RK. Hiatal hernia: myth or reality?. Am J Med. 1997;103(5A):33-9.

Dodds WJ. 1976 Walter B. Cannon lecture: current concepts of esophageal motor function--clinical implications for radiology. AJR Am J Roentgenol. 1977;128:549-61.