Hiatal hernia (General Surgery EOR - Smarty PANCE)

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Last updated 4:07 PM on 11/20/25
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12 Terms

1
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What is a sliding esophageal hiatal hernia?

Both the stomach and GE junction herniate into the thorax via the esophageal hiatus; also known as type I hiatal hernia

<p>Both the stomach and GE junction herniate into the thorax via the esophageal hiatus; also known as type I hiatal hernia</p>
2
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What is the incidence of hiatal hernia?

90% of all hiatal hernias

3
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What are the symptoms of hiatal hernia?

Most patients are asymptomatic, but the condition can cause reflux, dysphagia (from inflammatory edema), esophagitis, and pulmonary problems secondary to aspiration

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How is a hiatal hernia diagnosed?

UGI series, manometry, esophagogastroduodenoscopy (EGD) with biopsy for esophagitis

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What are the complications of hiatal hernia?

Reflux S esophagitis S Barrett's esophagus S cancer and stricture formation; aspiration pneumonia; it can also result in UGI bleeding from esophageal ulcerations

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What is the treatment of hiatal hernia?

85% of cases treated medically with antacids, H2 blockers/PPIs, head elevation after meals, small meals, and no food prior to sleeping; 15% of cases require surgery for persistent symptoms despite adequate medical treatment

7
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What is the surgical treatment of hiatal hernia?

Laparoscopic Nissen fundoplication (LAP NISSEN) involves wrapping the fundus around the LES and suturing it in place

8
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What is a paraesophageal hiatal hernia?

Herniation of all or part of the stomach through the esophageal hiatus into the thorax without displacement of the gastroesophageal junction; also known as type II hiatal hernia

<p>Herniation of all or part of the stomach through the esophageal hiatus into the thorax without displacement of the gastroesophageal junction; also known as type II hiatal hernia</p>
9
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What is the incidence of paraesophageal hiatal hernia?

5% of all hiatal hernias (rare)

10
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What are the symptoms of paraesophageal hiatal hernia?

Derived from mechanical obstruction; dysphagia, stasis gastric ulcer, and strangulation; many cases are asymptomatic and not associated with reflux because of a relatively normal position of the GE junction

11
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What are the complications of paraesophageal hiatal hernia?

Hemorrhage, incarceration, obstruction, and strangulation

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What is the treatment of paraesophageal hiatal hernia?

Surgical, because of frequency and severity of potential complications