"partial or total herniation of the stomach/gastro-oesophageal junction (GOJ) through the diaphragmatic hiatus, into the thoracic cavity"
Presentation:
Common, mostly > 50yrs
Can be asymptomatic/symptoms of reflux oesophagitis
Aetiology
Increased abdo pressure
Low residue diet
Laxity of diaphragmatic hiatus or peri-oesophageal attachments
Classification:
There are two main types of hiatus hernia:
- Sliding (most common)
- Para-oesophageal (5%)
It is x 4 more common in females.
Extreme cases - "upside down stomach" when the entire stomach herniates into the thoracic cavity.
Complications
Similar to reflux oesophagitis:
- mucosal erosions
- ulceration
- lower oesophageal stricture
- bleeding
- Barrett's Oesophagus
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