Hiatus hernia

• What is a hiatus hernia?


  Protrusion of part of the stomach through the diaphragmatic hiatus into the thoracic cavity
• What are the two types of hiatus hernia?


  Sliding

  Paraesophageal
• What are some risk factors for hiatus hernias?


  Age

  Female

  Obesity

  Smoking

  Straining

  Iatrogenic
• What is a sliding hiatus hernia?


  Gastroesophageal junction moves above the diaphragm with a portion of the stomach
• What is sliding hiatus hernia often associated with?


  GORD
• What is a paraesophageal hernia?


  Stomach herniates next to the GEJ
• How many a patient present with a hiatus hernia?


  GORD symptoms

  Chest pain

  Dyspepsia

  Oesophagitis

  Anaemia

  SOB
• How is a hiatus hernia investigated?


  Gastroscopy

  Barium swallow

  CXR
• What is the gold standard investigation for a hiatus hernia?


  Gastroscopy
• What are some DDx for hiatus hernia?


  GORD

  Peptic ulcer disease

  Gastric cancer
• What is the conservative management for hiatus hernia?


  Lifestyle modifications
• What is the pharmacological management for hiatus hernia?

  PPIs
• How is a hiatus hernia managed surgically?


  Laparoscopic fundoplication

  Hernia repair with mesh

  Emergency surgery for complications
• What are some complications for a hiatus hernia?


  Gastric volvulus

  Hernia strangulation

  GORD

  Barrett's oesophagus

  Oesophageal stricture