Topic 7: Hiatal Hernia

Question 1

hiatal hernia

Answer 1

protrusion of part of the stomach into the esophagus through an opening, or hiatus, in the diaphragm

Question 2

sliding hernia

Answer 2

the junction of the stomach and esophagus is above the diaphragm, and a part of the stomach slides through the hiatal opening in the diaphragm

Question 3

Paraoesophageal or rolling hernia

Answer 3

the fundus and greater curvature of the stomach rolling up through the diaphragm, forming a pocket alongside the esophagus

Question 4

causes of hiatal hernia

Answer 4

increase in intraabdominal pressure including pregnancy, obesity, ascites, tumors, physical exertion, heavy lifting continually

Question 5

clinical manifestations of hiatal hernia

Answer 5

· Some people are asymptomatic
· Similar manifestations as GERD

Question 6

complications associated with hiatal hernia

Answer 6

· GERD
· Esophagitis
· Hemorrhage from erosion
· Stenosis (narrowing of the esophagus)
· Ulcerations of the herniates part of the stomach
· Strangulation of the hernia
Regurgitation with tracheal aspiration

Question 7

diagnostic study for hiatal hernia

Answer 7

· Esophagram (Barium Swallow)

Question 8

lifestyle modifications for hiatal hernia

Answer 8

· Eliminate alcohol
· Elevate head of bed (place 3-4” blocks of wood under the head bed posts)
· Stop smoking
· Avoid lifting/straining
· Reduce weight, if appropriate
· Use antisecretory agents and antacids

Question 9

patient teaching for hiatal hernia

Answer 9

Teach the patient to reduce intrabdominal pressure by eliminating constricting garments and avoid lifting and straining

Question 10

Herniotomy

Answer 10

excision of hernia sac

Question 11

herniorrhaphy

Answer 11

closure of hiatal defect

Question 12

Fundoplication

Answer 12

a surgical technique used to suture the fundus of the stomach around the esophagus to prevent reflux

Question 13

gastropexy

Answer 13

attachment of the stomach below the diaphragm to prevent re-herniation