hiatal hernia


Summary: STOMACH herniation located at or near the diaphragmatic opening for the ESOPHAGUS, the esophageal hiatus.

Top Publications

  1. Oishi Y, Ishimoto T, Nagase N, Mori K, Fujimoto S, Hayashi S, et al. Syncope upon swallowing caused by an esophageal hiatal hernia compressing the left atrium: a case report. Echocardiography. 2004;21:61-4 pubmed
    ..This syncope was caused by transient compression of the left atrium (LA) by an esophageal hiatal hernia. Two-dimensional echocardiography demonstrated a hyperechoic mass compressing the LA from the posterior...
  2. Hergueta Delgado P, Marín Moreno M, Morales Conde S, Reina Serrano S, Jurado Castillo C, Pellicer Bautista F, et al. Transmural migration of a prosthetic mesh after surgery of a paraesophageal hiatal hernia. Gastrointest Endosc. 2006;64:120; discussion 121 pubmed
  3. Khouzam R, Akhtar A, Minderman D, Kaiser J, D Cruz I. Echocardiographic aspects of hiatal hernia: A review. J Clin Ultrasound. 2007;35:196-203 pubmed
    ..These include the combination of hiatal hernia with gastroesophageal reflux demonstrable in the subcostal view, and hiatal hernia in patients with ascites.
  4. Müller Stich B, Holzinger F, Kapp T, Klaiber C. Laparoscopic hiatal hernia repair: long-term outcome with the focus on the influence of mesh reinforcement. Surg Endosc. 2006;20:380-4 pubmed
    ..The follow-up period averaged 52 +/- 31 months (range, 9-117 months). The recurrence rate for hiatal hernia without mesh reinforcement was 19% (7/36)...
  5. Gupta M, Nanda N, Inamdar V. Two- and three-dimensional transthoracic echocardiographic assessment of hiatal hernia. Echocardiography. 2008;25:790-3 pubmed publisher
    ..lesion behind the left ventricular posterior wall in an elderly female was definitively diagnosed as a hiatal hernia. A 3DTTE provided a more comprehensive evaluation of the hiatal hernia as compared to the 2DTTE in terms of ..
  6. Dutta S. Prosthetic esophageal erosion after mesh hiatoplasty in a child, removed by transabdominal endogastric surgery. J Pediatr Surg. 2007;42:252-6 pubmed
    ..is evidence in the adult surgical literature to suggests that the use of mesh prosthesis during laparoscopic hiatal hernia repair results in much reduced recurrence rates, there remains a real potential for esophageal and gastric ..
  7. Johnson J, Carbonell A, Carmody B, Jamal M, Maher J, Kellum J, et al. Laparoscopic mesh hiatoplasty for paraesophageal hernias and fundoplications: a critical analysis of the available literature. Surg Endosc. 2006;20:362-6 pubmed
    ..Laparoscopic procedures (n = 1,368) were performed for PEH, gastroesophageal reflux disease (GERD), hiatal hernia, or a combination of the three...
  8. Wisbach G, Peterson T, Thoman D. Early results of the use of acellular dermal allograft in type III paraesophageal hernia repair. JSLS. 2006;10:184-7 pubmed
    ..Postoperatively, 9 of 11 patients reported no symptoms. Barium esophagram revealed one recurrence in an asymptomatic patient. Type III paraesophageal hernia can be laparoscopically repaired successfully with acellular dermal allografts. ..
  9. El Sherif A, Yano F, Mittal S, Filipi C. Collagen metabolism and recurrent hiatal hernia: cause and effect?. Hernia. 2006;10:511-20 pubmed
    ..The relationship between collagen and HH, and its recurrence, is not fully understood and needs further investigation. ..

More Information


  1. Oelschlager B, Pellegrini C, Hunter J, Soper N, Brunt M, Sheppard B, et al. Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair: a multicenter, prospective, randomized trial. Ann Surg. 2006;244:481-90 pubmed
    ..8 vs. 1.3, P = 0.02) and worse physical functioning (63 vs. 72, P = 0.03 per SF-36). Adding a biologic prosthesis during LPEHR reduces the likelihood of recurrence at 6 months, without mesh-related complications or side effects. ..
  2. Desai K, Diaz S, Dorward I, Winslow E, La Regina M, Halpin V, et al. Histologic results 1 year after bioprosthetic repair of paraesophageal hernia in a canine model. Surg Endosc. 2006;20:1693-7 pubmed
    The use of prosthetic materials for the repair of paraesophageal hiatal hernia (PEH) may lead to esophageal stricture and perforation...
  3. Rezailashkajani M, Roshandel D, Shafaee S, Zali M. High prevalence of reflux oesophagitis among upper endoscopies of Iranian patients. Eur J Gastroenterol Hepatol. 2007;19:499-506 pubmed
    ..This study showed a significantly higher prevalence of reflux esophagitis among Iranian upper-endoscopy outpatients compared with the findings of non-Iranian studies. ..
  4. Smelley M, Lang R. Large mass impinging on the left atrium: diagnostic value of a new cocktail. J Am Soc Echocardiogr. 2007;20:1414.e5-7 pubmed
    The differential for a large mass impinging on the left atrium should include a hiatal hernia. When a hiatal hernia is suspected, the patient can be asked to ingest a carbonated beverage...
  5. Granderath F, Carlson M, Champion J, Szold A, Basso N, Pointner R, et al. Prosthetic closure of the esophageal hiatus in large hiatal hernia repair and laparoscopic antireflux surgery. Surg Endosc. 2006;20:367-79 pubmed
    ..the standard surgical approach to both surgery for gastroesophageal reflux disease and large/paraesophageal hiatal hernia repair with excellent long-term results and high patient satisfaction...
  6. Draaisma W, Gooszen H, Tournoij E, Broeders I. Controversies in paraesophageal hernia repair: a review of literature. Surg Endosc. 2005;19:1300-8 pubmed
    ..Treatment based on standardized protocols for preoperative assessment and postoperative follow-up is required to clarify the current controversies. ..
  7. Hiyama T, Yoshihara M, Tanaka S, Haruma K, Chayama K. Strategy for treatment of nonerosive reflux disease in Asia. World J Gastroenterol. 2008;14:3123-8 pubmed
    ..of NERD patients in Asia are as follows: (1) high proportion of female patients, (2) low frequency of hiatal hernia, (3) high frequency of H pylori infection, (4) severe glandular atrophy of the gastric mucosa, and (5) ..
  8. Koskinas K, Oikonomou K, Karapatsoudi E, Makridis P. Echocardiographic manifestation of hiatus hernia simulating a left atrial mass: case report. Cardiovasc Ultrasound. 2008;6:46 pubmed publisher
    ..Physicians should be aware of the clinical and sonographic findings to facilitate the differential diagnosis from similarly presenting cardiac entities. ..
  9. Low D, Unger T. Open repair of paraesophageal hernia: reassessment of subjective and objective outcomes. Ann Thorac Surg. 2005;80:287-94 pubmed
    ..Results with the open approach in the modern era can provide excellent outcomes, which are comparable to and in some measures exceed those obtained with the laparoscopic approach. ..
  10. Hui T, Thoman D, Spyrou M, Phillips E, David T. Mesh crural repair of large paraesophageal hiatal hernias. Am Surg. 2001;67:1170-4 pubmed
    ..All others remained asymptomatic. We conclude that the use of mesh in laparoscopic repair of large paraesophageal hernias appears safe and may reduce recurrence. ..
  11. Mattar S, Bowers S, Galloway K, Hunter J, Smith C. Long-term outcome of laparoscopic repair of paraesophageal hernia. Surg Endosc. 2002;16:745-9 pubmed
    ..The complication and death rates may be related in part to the higher incidence of comorbidities in this somewhat elderly patient population. ..
  12. Kamolz T, Granderath F, Bammer T, Pasiut M, Pointner R. Dysphagia and quality of life after laparoscopic Nissen fundoplication in patients with and without prosthetic reinforcement of the hiatal crura. Surg Endosc. 2002;16:572-7 pubmed
    Recurrent hiatal hernia with or without intrathoracic wrap migration ("slipping Nissen") is one of the most common complications after laparoscopic Nissen fundoplication (LNF)...
  13. Champion J, Rock D. Laparoscopic mesh cruroplasty for large paraesophageal hernias. Surg Endosc. 2003;17:551-3 pubmed
  14. Choi D, Oh S, Baek S, Ahn S, Chang Y, Jeong W, et al. Endoscopically observed lower esophageal capillary patterns. Korean J Intern Med. 2002;17:245-8 pubmed
    ..and patterns of PZ in Koreans, and to assess the prevalence of endoscopic Barrett's esophagus (E-BE) and hiatal hernia (E-HH). 847 consecutive patients undergoing diagnostic endoscopy were included...
  15. Maruyama T, Fukue M, Imamura F, Nozue M. Incarcerated paraesophageal hernia associated with perforation of the fundus of the stomach: report of a case. Surg Today. 2001;31:454-7 pubmed
    ..Her history included an esophageal hiatal hernia. A laparotomy was performed which revealed that the antrum of stomach and the duodenal bulb had prolapsed into ..
  16. Fujiwara Y, Higuchi K, Shiba M, Yamamori K, Watanabe Y, Sasaki E, et al. Differences in clinical characteristics between patients with endoscopy-negative reflux disease and erosive esophagitis in Japan. Am J Gastroenterol. 2005;100:754-8 pubmed
    ..27, 95% CI, 1.25-4.10), smoking (OR = 0.45, 95% CI, 0.22-0.91), and the presence of hiatal hernia (OR = 0.30, 95% CI, 0.17-0...
  17. Leeder P, Smith G, Dehn T. Laparoscopic management of large paraesophageal hiatal hernia. Surg Endosc. 2003;17:1372-5 pubmed
    ..The postoperative morbidity rate was 13%, with one death. Laparoscopic repair of large POHs remains feasible. We advocate complete sac excision, hiatal repair, fundoplication, and gastropexy to prevent early recurrence. ..
  18. Oelschlager B, Barreca M, Chang L, Pellegrini C. The use of small intestine submucosa in the repair of paraesophageal hernias: initial observations of a new technique. Am J Surg. 2003;186:4-8 pubmed
    ..One morbidly obese (body mass index = 47) patient had a small (2 cm) sliding hiatal hernia postoperatively. There were no other complications, and specifically no perforations or mesh erosions...
  19. Ronkainen J, Aro P, Storskrubb T, Johansson S, Lind T, Bolling Sternevald E, et al. High prevalence of gastroesophageal reflux symptoms and esophagitis with or without symptoms in the general adult Swedish population: a Kalixanda study report. Scand J Gastroenterol. 2005;40:275-85 pubmed
    ..pylori infection (OR = 1.71 (1.23 2.38)). GERS and EE (of which one-third is asymptomatic) are highly prevalent in the Swedish adult population. H. pylori infection seems to play a role in the manifestations of gastroesophageal reflux. ..
  20. Ferri L, Feldman L, Stanbridge D, Mayrand S, Stein L, Fried G. Should laparoscopic paraesophageal hernia repair be abandoned in favor of the open approach?. Surg Endosc. 2005;19:4-8 pubmed
    ..11). Laparoscopic repair should remain in the forefront for the management of paraesophageal hernias. However, there is considerable room for improvement in reducing the incidence of recurrence. ..
  21. Frans E, Nanda N, Patel V, Vengala S, Mehmood F, Fonbah W, et al. Transesophageal two-dimensional echocardiographic identification of hiatal hernia. Echocardiography. 2005;22:533-5 pubmed
    ..We were able to make a definitive diagnosis of this mass as a hiatal hernia because of a thick inner lining measuring 6-9 mm in thickness similar to the stomach mucosa, and the presence ..
  22. Quigley E. New developments in the pathophysiology of gastro-oesophageal reflux disease (GERD): implications for patient management. Aliment Pharmacol Ther. 2003;17 Suppl 2:43-51 pubmed
  23. Terry M, Smith C, Branum G, Galloway K, Waring J, Hunter J. Outcomes of laparoscopic fundoplication for gastroesophageal reflux disease and paraesophageal hernia. Surg Endosc. 2001;15:691-9 pubmed
    ..Beyond 1 year (median follow-up period, 27 months), 94% of the reviewed patients were satisfied with their surgical outcome. ..
  24. Granderath F, Schweiger U, Kamolz T, Asche K, Pointner R. Laparoscopic Nissen fundoplication with prosthetic hiatal closure reduces postoperative intrathoracic wrap herniation: preliminary results of a prospective randomized functional and clinical study. Arch Surg. 2005;140:40-8 pubmed
    ..Previous authors have studied the use of prosthetic materials for hiatal closure to prevent recurrence of hiatal hernia and/or postoperative intrathoracic wrap herniation...
  25. Stylopoulos N, Gazelle G, Rattner D. Paraesophageal hernias: operation or observation?. Ann Surg. 2002;236:492-500; discussion 500-1 pubmed
  26. Bandorski D, Hönscher R, Ibing R, Rieker W. [A 77-year-old patient with suspected left atrial tumor]. Internist (Berl). 2004;45:1047-52 pubmed
    ..There was a hiatal hernia which compressed the left atrium from outside...
  27. Targarona E, Bendahan G, Balague C, Garriga J, Trias M. Mesh in the hiatus: a controversial issue. Arch Surg. 2004;139:1286-96; discussion 1296 pubmed
    ..The mesh should be used selectively, and the decision to proceed should be based on clinical experience. In light of the evidence available, however, it appears to be safe, and the fears expressed in the past have not been confirmed. ..
  28. Samujh R, Kumar D, Rao K. Paraesophageal hernia in the neonatal period: suspicion on chest X-ray. Indian Pediatr. 2004;41:189-91 pubmed
    ..Two neonates with para-esophageal hernia are reported, one with the mesenterico-axial volvulus and the second neonate without volvulus. ..
  29. Patel H, Tan B, Yee J, Orringer M, Iannettoni M. A 25-year experience with open primary transthoracic repair of paraesophageal hiatal hernia. J Thorac Cardiovasc Surg. 2004;127:843-9 pubmed
    The optimal surgical treatment of paraesophageal hiatal hernia is in debate...
  30. Strange P. Small intestinal submucosa for laparoscopic repair of large paraesophageal hiatal hernias: a preliminary report. Surg Technol Int. 2003;11:141-3 pubmed
    ..Nine of these 12 patients have had barium studies at six months post-procedure and seven at one year. No failures demonstrated. ..
  31. Greub G, Liaudet L, Wiesel P, Bettschart V, Schaller M. Respiratory complications of gastroesophageal reflux associated with paraesophageal hiatal hernia. J Clin Gastroenterol. 2003;37:129-31 pubmed
    ..GERD is frequently observed in the setting of type 1 (sliding type) hiatal hernia, but only infrequently complicates the course of type 2 (paraesophageal) hernia...
  32. Pierre A, Luketich J, Fernando H, Christie N, Buenaventura P, Litle V, et al. Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg. 2002;74:1909-15; discussion 1915-6 pubmed
    ..Median follow-up was 18 months. Five patients required reoperation for recurrent hiatal hernia. Excellent results were reported in 128 (84%) patients, 12 (8%) had a good result, 7 (5%) fair, and 5 (3%) ..
  33. Ueda T, Mizushige K. Large hiatus hernia compressing the heart and impairing the respiratory function. J Cardiol. 2003;41:211; author reply 211-2 pubmed
  34. Siu C, Jim M, Ho H, Chu F, Chan H, Lau C, et al. Recurrent acute heart failure caused by sliding hiatus hernia. Postgrad Med J. 2005;81:268-9 pubmed
    ..Cardiac catheterisation confirmed the diagnosis by showing a pronounced rise of pulmonary capillary wedge pressure in the recumbent position compared with the sitting up position. ..
  35. Pandolfino J, Shi G, Curry J, Joehl R, Brasseur J, Kahrilas P. Esophagogastric junction distensibility: a factor contributing to sphincter incompetence. Am J Physiol Gastrointest Liver Physiol. 2002;282:G1052-8 pubmed
  36. van der Zee D, Bax N, Kramer W, Mokhaberi B, Ure B. Laparoscopic management of a paraesophageal hernia with intrathoracic stomach in infants. Eur J Pediatr Surg. 2001;11:52-4 pubmed
    ..Recently two children presented with a large type III paraesophageal hernia with an intrathoracic stomach. The stomach could be retrieved from the thorax laparoscopically and the procedure was completed with a Thai antireflux procedure. ..
  37. Kahrilas P, Shi G, Manka M, Joehl R. Increased frequency of transient lower esophageal sphincter relaxation induced by gastric distention in reflux patients with hiatal hernia. Gastroenterology. 2000;118:688-95 pubmed
    This study aimed to determine if hiatal hernia influences vulnerability to reflux and transient lower esophageal sphincter relaxation (tLESR) during gastric distention in patients with gastroesophageal reflux disease (GERD)...
  38. Kahrilas P. The role of hiatus hernia in GERD. Yale J Biol Med. 1999;72:101-11 pubmed
    ..Thus, although hiatus hernia may or may not be an initiating factor at the inception of reflux disease, it clearly can act as a sustaining factor accounting for the frequently observed chronicity of the disease. ..
  39. Barak N, Ehrenpreis E, Harrison J, Sitrin M. Gastro-oesophageal reflux disease in obesity: pathophysiological and therapeutic considerations. Obes Rev. 2002;3:9-15 pubmed
    ..First, obese subjects are more sensitive to the presence of acid in the oesophagus. Second, hiatal hernia, capable of promoting GERD by several mechanisms, is more prevalent among the obese...
  40. Casaccia M, Torelli P, Panaro F, Cavaliere D, Ventura A, Valente U. Laparoscopic physiological hiatoplasty for hiatal hernia: new composite "A"-shaped mesh. Physical and geometrical analysis and preliminary clinical results. Surg Endosc. 2002;16:1441-5 pubmed
    ..No recurrence was observed at an 8-month average follow-up. The preliminary clinical study confirms the feasibility of this tension-free repair and the effectiveness of this composite A-shaped mesh. ..
  41. Jobe B, Aye R, Deveney C, Domreis J, Hill L. Laparoscopic management of giant type III hiatal hernia and short esophagus. Objective follow-up at three years. J Gastrointest Surg. 2002;6:181-8; discussion 188 pubmed
    We wished to evaluate the long-term effectiveness of the laparoscopic Hill repair in the treatment of type III hiatal hernia. Fifty-two patients underwent laparoscopic repair of a type III hiatal hernia...
  42. Wiechmann R, Ferguson M, Naunheim K, McKesey P, Hazelrigg S, Santucci T, et al. Laparoscopic management of giant paraesophageal herniation. Ann Thorac Surg. 2001;71:1080-6; discussion 1086-7 pubmed
    ..Control of the herniation and the patient's symptoms are equivalent and hospitalization and return to full activity are shorter. ..
  43. Hokamaki J, Kawano H, Miyamoto S, Sugiyama S, Fukushima R, Sakamoto T, et al. Dynamic electrocardiographic changes due to cardiac compression by a giant hiatal hernia. Intern Med. 2005;44:136-40 pubmed
    ..Echocardiography demonstrated a mass compressing the heart and computed tomography revealed a giant hiatal hernia within the intrathoracic stomach located just behind the heart...
  44. Otsuka Y, Nara S, Ito K, Nakajima K, Mieno H, Konishi T. Perforated duodenal ulcer associated with an incarcerated hiatal hernia: report of a case. Surg Today. 2002;32:1085-7 pubmed
    We report the case of a perforated duodenal ulcer and diffuse peritonitis associated with an incarcerated hiatal hernia. A 77-year-old woman with a 17-year history of rheumatoid arthritis treated with nonsteroidal anti-inflammatory drugs,..
  45. Frantzides C, Madan A, Carlson M, Stavropoulos G. A prospective, randomized trial of laparoscopic polytetrafluoroethylene (PTFE) patch repair vs simple cruroplasty for large hiatal hernia. Arch Surg. 2002;137:649-52 pubmed
    ..There were 8 hernia recurrences (22%) in the primary repair group and none in the PTFE group (P<.006). The use of prosthetic reinforcement of cruroplasty in large hiatal hernias may prevent hernia recurrences. ..
  46. Akdemir I, Davutoglu V, Aktaran S. Giant hiatal hernia presenting with stable angina pectoris and syncope--a case report. Angiology. 2001;52:863-5 pubmed
    A 70-year-old woman with giant hiatal hernia presented with stable angina pectoris and three syncope attacks in the previous 3 months. Chest radiography showed marked cardiomegaly and an air-fluid level at the basal region of the heart...
  47. Jones M, Sloan S, Rabine J, Ebert C, Huang C, Kahrilas P. Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease. Am J Gastroenterol. 2001;96:1711-7 pubmed
    ..Logistic regression was performed grouping subjects as controls, nonerosive GERD, or erosive esophagitis. Hiatal hernia size, lower esophageal sphincter pressure, esophageal acid exposure, and number of reflux episodes >5 min ..
  48. Diaz S, Brunt L, Klingensmith M, Frisella P, Soper N. Laparoscopic paraesophageal hernia repair, a challenging operation: medium-term outcome of 116 patients. J Gastrointest Surg. 2003;7:59-67 pubmed publisher
    ..Protocol barium esophagograms were obtained in 69% of patients at 6 to 12 months' follow-up. Recurrence of hiatal hernia was documented in 21 patients (22% overall and in 32% of those undergoing contrast studies)...
  49. van Herwaarden M, Samsom M, Smout A. Excess gastroesophageal reflux in patients with hiatus hernia is caused by mechanisms other than transient LES relaxations. Gastroenterology. 2000;119:1439-46 pubmed
  50. Saxena P, Konstantinov I, Koniuszko M, Ghosh S, Low V, Newman M. Hiatal herniation of the pancreas: diagnosis and surgical management. J Thorac Cardiovasc Surg. 2006;131:1204-5 pubmed
  51. Stetler J, Gill S, Patel A, Davis S, Lin E. Surgical Technique for Laparoscopic Removal of a Magnetic Lower Esophageal Sphincter Augmentation Device. J Laparoendosc Adv Surg Tech A. 2015;25:1025-8 pubmed publisher
    ..a laparoscopic placement of a magnetic lower esophageal sphincter augmentation device and repair of a small hiatal hernia. She had a complicated postoperative course before presenting to our institution with a 2-year history of ..
  52. Masumoto K, Suita S, Taguchi T. Oesophageal atresia with a terminal deletion of chromosome 2q37.1. Clin Dysmorphol. 2006;15:213-6 pubmed
    ..In addition, she had a terminal deletion of the long arm of chromosome 2, with a breakpoint of 2q37.1. The patient died following a cardiac arrest at 90 days of age. No cause of death was identified at autopsy. ..
  53. Hodde J, Hiles M. Constructive soft tissue remodelling with a biologic extracellular matrix graft: overview and review of the clinical literature. Acta Chir Belg. 2007;107:641-7 pubmed
    ..The tissue response to this biologic mesh is discussed in the context of recent reports on successful clinical applications. ..