Overview
- This refers to herniation of the stomach through the diaphragm
- The diaphragm opening should be at the level of the lower oesophageal sphincter and should be fixed in place
- The opening helps to maintain a narrow sphincter that stops acid and stomach contents refluxing into the oesophagus
- When there is herniation and broadening of the diaphragm opening, this allows contents to reflux up into the oesophagus and give reflux symptoms
- Treatment is either conservative (with medical treatment of reflux) or surgical repair if high risk of complication or causing severe symptoms
Types
- Sliding (AKA Type 1 Hiatus Hernia)
- The stomach slides up along with the oesophagus through the diaphragm
- Rolling (AKA Type 2 Hiatus Hernia)
- A separate portion of the stomach (i.e. the fundus), folds around and enters through the diaphragm opening along with the oesophagus
- Type 3 Hiatus Hernia
- A combination of a sliding and rolling hiatus hernia
- Type 4 Hiatus Hernia
- A large hernia allows other intraabdominal organs to pass through the diaphragm opening (e.g. bowel, pancreas, omentum)
