Hiatus Hernia Flashcards
What are the 2 types of hiatus hernia?
Sliding and Rolling
What is a sliding hiatus hernia?
Part of the stomach at the Gastro-oesophageal junction is pushed into the diaphragm
What does a sliding hiatus hernia remove?
The natural anatomical barrier to reflux
What is there an increased incidence of with a hiatus hernia?
Gastro-oesophageal reflux disease
What is a rolling hiatus hernia?
Fundus of the stomach extends through the diaphragm at a separate site to the oesophagus
How is a rolling hernia often discovered?
By accident on a chest x-ray
When may a rolling hernia present earlier?
If it strangulated
How is a hiatus hernia diagnosed?
Barium swallow test- most sensitive test
Usually discovered on upper GI endoscopy incidentally
What is lifestyle management of a hiatus hernia?
Lose weight
What is surgical management of a hiatus hernia?
Laparoscopic fundoplication hepatoma
When would you consider surgical management for a hiatus hernia?
There are symptoms despite aggressive medical treatment
What are possible symptoms of a hiatus hernia?
Pain and discomfort after eating
heartburn
dysphagia
regurgitation
chest pain
How can a slding hiatus hernia be managed?
Similarly to GORD
What are the main RF for a hiatus hernia?
obesity
pregnancy (increased intra-abdominal pressure)
What is the medical management of a hiatus hernia?
PPI for 4-8 weeks
