Hiatus Hernia Flashcards
What is hiatus hernia?
Hiatus hernia is an extremely common anatomical abnormality. It refers to the herniation of part of the stomach through an opening in the diaphragm known as the oesophageal hiatus. This opening functions to allow the oesophagus to pass through the diaphragm into the abdominal cavity.
What are the risk factors of hiatus hernia?
older age, male, obesity.
What are the four classifications of hiatus hernia?
1) Type I (sliding): displacement of the gastro-oesophageal junction (GOJ) above the diaphragm. Account for >95% of hiatal hernias and usually asymptomatic
2) Type II (para-oesophageal): herniation of the gastric fundus through a defect in the phrenoesophageal membrane. The GOJ remains below the diaphragm. The least common type of para-oesophageal hernia
3) Type III (para-oesophageal): a combination of type I and II hernias. Both the gastric fundus and GOJ herniate through the oesophageal hiatus and lie above the diaphragm. The most common type of para-oesophageal hernia
4) Type IV (para-oesophageal): characterised by the presence of other organs within the hernial sac above the diaphragm (e.g. large bowel, small bowel). Usually, there is significant displacement of the stomach above the diaphragm due to a large defect in the phrenoesophageal membrane. As the stomach herniates through it may twist on its longitudinal or horizontal axis leading to a gastric volvulus.
