Hiatus Hernia Flashcards
What is a Hiatus Hernia?
Herniation of part of the stomach through the diaphragm via the oesophageal hiatus.
Hiatus Hernia can lead to various complications if not managed properly.
What are the two main types of Hiatus Hernia?
- Sliding
- Rolling/paraoesophageal
Sliding is the most common type, while rolling/paraoesophageal has a different mechanism.
Describe the Sliding Hiatus Hernia.
Gastro-osophageal junction slides upwards through hiatus; GORD is common in this presentation.
GORD stands for Gastro-Oesophageal Reflux Disease.
Describe the Rolling/Paraoesophageal Hiatus Hernia.
GOJ remains in the abdomen, fundus of stomach slides upwards through the hiatus.
GORD is less common in this type of hernia.
What are some risks for developing a Hiatus Hernia?
- Obesity
- Pregnancy
- Ascites
- Chronic cough
- Constipation
These conditions increase intra-abdominal pressure, contributing to hernia formation.
What are the clinical features of a Hiatus Hernia?
- May be ASYMPTOMATIC (small hernia)
- Epigastric pain
- Dysphagia
- Heartburn
- Nausea/Vomiting
- Regurgitation
Symptoms can vary significantly based on the size and type of hernia.
What is the most sensitive investigation for Hiatus Hernia?
Barium Swallow.
This test can detect the presence of a hernia effectively.
What is a common finding on a CXR for Hiatus Hernia?
Gastric bubble in thoracic cavity.
CXR is not the best test for diagnosing hiatus hernia.
How is Hiatus Hernia often discovered?
Most commonly found by mistake during OGD.
OGD stands for Oesophagogastroduodenoscopy.
What are the management options for asymptomatic Hiatus Hernia?
NO treatment.
Asymptomatic cases typically do not require intervention.
What lifestyle changes can help manage Hiatus Hernia?
- Weight loss
- Elevate head of bed
- Avoid meals close to bedtime
These changes can reduce symptoms and improve quality of life.
What medical treatment is commonly used for Hiatus Hernia?
PPIs to reduce symptoms of GORD
PPIs stand for Proton Pump Inhibitors, which help reduce stomach acid.
What surgical procedure is typically performed for Hiatus Hernia?
Nissen’s fundoplication + laparoscopic repair.
This procedure involves wrapping the fundus of the stomach around the oesophagus to prevent reflux.
What is a serious complication of Hiatus Hernia?
Strangulation of hiatal hernia.
Strangulation can lead to significant complications, including necrosis of the stomach tissue.
