Hiatus Hernia

Question 1

What percentage of over 50s will develop hiatus hernia?

Answer 1

50%

Question 2

What proportion of those affected will have reflux?

Answer 2

Only 1/3

Question 3

What are the two types?

Answer 3

Sliding and rolling

Question 4

What proportion are sliding vs rolling?

Answer 4

80 sliding to 20 rolling

Question 5

What happens in a sliding hiatus hernia?

Answer 5

Gastro - oesophageal junction slides into the thorax. Very commonly associated with reflux

Question 6

What happens in a rolling hiatus hernia?

Answer 6

Part of the proximal stomach moves into the thorax next to the oesophagus while the LOS remains in the abdomen. Usually asymptomatic, reflux very rare

Question 7

What investigations are done?

Answer 7

Endoscopy or barium swallow

Question 8

How are they treated?

Answer 8

Rolling - Fundoplication if necessary

Sliding conservative, surgery is required

Question 9

How does it happen?

Answer 9

The proximal stomach herniates from the abdomen into the thorax via the diaphragmatic hiatus