Hiatus Hernia

Question 1

what is it?

Answer 1

herniation of GOJ and/or proximal part of stomach through diaphragm and into thorax

Question 2

classification?

Answer 2

• Sliding (80%)
  
  • GOJ enters thorax
  • often associated w GORD
• Rolling (5%)
  
  • proximal part of stomach enters into thorax
  • LOS intact so GORD uncommon
• Mixed
  
  • combination of both

Question 3

aetiology?

Answer 3

• obesity
• >50y/o
• women

Question 4

presentation?

Answer 4

asymptomatic / GORD

Question 5

Ix?

Answer 5

• Barium swallow
• CXR

Question 6

Mx?

Answer 6

• conservative: lose weight, lifestyle changes & medical treatment as per GORD
• surgical indicated in rolling (risk of strangulation) –> fundoplication