Open AccessThe Cause of Dysphagia in Uncomplicated Sliding Hiatal Hernia and its Relief by Hiatal Herniorrhaphy
Author(s) -
B. Kaul,
Tom R. DeMeester,
Masaaki Oka,
Chris S. Ball,
Hubert J. Stein,
Choong B. Kim,
Shih-Chuan Cheng
Publication year - 1990
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-199004000-00005
Subject(s) - medicine , hiatal hernia , dysphagia , surgery , hernia , general surgery , disease , reflux
Patients with an uncomplicated sliding hiatal hernia frequently experience dysphagia. The present study shows, using video barium contrast esophagograms, that the cause of dysphagia in 60% of these patients is an obstruction to the passage of the swallowed bolus by diaphragmatic impingement on the herniated stomach. Manometrically this was reflected by a double-hump high pressure zone (HPZ) at the gastroesophageal junction, and specifically to the length and amplitude of the distal HPZ and the length of the intervening segment between the two HPZs. The former represents the degree of the diaphragmatic impingement on the herniated stomach and the latter the size of the supradiaphragmatic herniated stomach. Surgical reduction of the hernia resulted in relief of dysphagia in 91% of the patients.