Gastroenterology Book

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Diaphragmatic Hernia

Aka: Diaphragmatic Hernia, Hiatal Hernia
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  1. Pathophysiology
    1. Stomach herniation via esophageal hiatus of diaphragm
  2. Types
    1. Type I: Sliding Hiatal Hernia (accounts for 95% of cases)
    2. Type II: Paraesophageal herniation
      1. Complication of Anti-Reflux Surgery
      2. Risk of gastric Volvulus (surgical emergency)
      3. Surgical repair is indicated if symptoms occur
        1. Wiechman (2001) Ann Thorac Surg 71:1030-1037
  3. Symptoms
    1. See Gastroesophageal Reflux
    2. Pain in epigastrium or lower chest
      1. Worse on reclining
      2. Relieved on standing
      3. Pain may be retrosternal with radiation down left arm
    3. Hematemesis
  4. Signs
    1. Normal exam unless large hernia
    2. Left lung base
      1. Dullness to percussion
      2. Absent breath sounds
      3. Bowel sounds present
  5. Differential diagnosis
    1. Angina Pectoris
    2. Gastroesophageal Reflux
  6. Diagnostics
    1. Barium swallow (UGI)
      1. Stomach herniated above diaphragm
    2. Upper endoscopy
      1. Poor at identifying Hiatal Hernia
      2. Indicated to evaluate for esophageal or gastric malignancy or Eosinophilic esophagitis

Diaphragmatic Hernia (C0019284)

Definition (NCI) A congenital or acquired weakness or opening in the diaphragm which allows abdominal contents to protrude into the chest cavity; congenital diaphragmatic hernias are caused when the embryonic diaphragm fails to fuse.
Definition (CHV) a condition where a part of the stomach protrudes through the esophageal opening of the diaphragm
Definition (CHV) a condition where a part of the stomach protrudes through the esophageal opening of the diaphragm
Definition (CHV) a condition where a part of the stomach protrudes through the esophageal opening of the diaphragm
Definition (CHV) a condition where a part of the stomach protrudes through the esophageal opening of the diaphragm
Definition (MEDLINEPLUS)

A hiatal hernia is a condition in which the upper part of the stomach bulges through an opening in the diaphragm. The diaphragm is the muscle wall that separates the stomach from the chest. The diaphragm helps keep acid from coming up into the esophagus. When you have a hiatal hernia, it's easier for the acid to come up. The leaking of acid from the stomach into the esophagus is called gastroesophageal reflux (GERD). GERD may cause symptoms such as

  • Heartburn
  • Problems swallowing
  • A dry cough
  • Bad breath

Hiatal hernias are common, especially in people over age 50. If you have symptoms, eating small meals, avoiding certain foods, not smoking or drinking alcohol, and losing weight may help. Your doctor may recommend antacids or other medicines. If these don't help, you may need surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Definition (MSH) STOMACH herniation located at or near the diaphragmatic opening for the ESOPHAGUS, esophageal hiatus. When the ESOPHAGOGASTRIC JUNCTION is above the DIAPHRAGM, it is called a SLIDING HIATAL HERNIA. When the ESOPHAGOGASTRIC JUNCTION is below the DIAPHRAGM, it is called a PARAESOPHAGEAL HIATAL HERNIA.
Definition (MSH) Protrusion of abdominal structures into the THORAX as a result of congenital or traumatic defects in the respiratory DIAPHRAGM.
Concepts Disease or Syndrome (T047) , Anatomical Abnormality (T190)
MSH D006548, D006551
ICD10 K44, K44.9
SnomedCT 155750007, 196914007, 309811003, 196912006, 266444006, 84089009, 39839004, 155748004, 196901006, 266511003, 196911004
English Hernia, hiatus, Diaphragmatic Hernias, Hernia, Diaphragmatic, Hernia, Hiatal, Hernias, Diaphragmatic, Hernias, Hiatal, Hiatal Hernia, Hiatal Hernias, DIAPHRAGMATIC HERNIA, HERNIA, DIAPHRAGMATIC, HIATUS HERNIA, Hernia, diaphragmatic, Hernia, hiatal, Diaphragmatic hernia, NOS, HERNIA HIATAL, Diaphragmatic hernia NOS, Unspecif.diaphragmatic hernia, Unspecified diaphragmatic hernia, Diaphragmatic/hiatus hernia, Bergmann's syndrome, Hiatus hernia syndrome, HERNIA, HIATUS, HIATAL HERNIA, Hiatus hernia NOS, Diaphragmatic Hernia, diaphragmatic hernia, hiatal hernia (diagnosis), hiatal hernia, diaphragmatic hernia (diagnosis), Diaphragmatic hernia NOS (disorder), Hiatus hernia NOS (disorder), H hernia, Hernia hiatal, Unspecified diaphragmatic hernia (disorder), Hernia, Hiatal [Disease/Finding], Hernia, Diaphragmatic [Disease/Finding], hernia diaphragmatic, hiatal hernias, Hernia;diaphragmatic, Hernia;hiatus, diaphragmatic hernias, esophageal hiatal hernia, diaphragmatics hernias, Hiatus hernia (diagnosis), Diaphragmatic hernias, Hiatal hernia, Esophageal hiatal hernia, Diaphragmatic hernia, Esophageal hiatus hernia, Hiatus hernia, Oesophageal hiatus hernia, Oesophageal hiatal hernia, HH - Hiatus hernia, Diaphragmatic hernia (disorder), Hiatal hernia (disorder), diaphragmatic; hernia, hernia; diaphragmatic, hernia; hiatal, hiatal; hernia, Diaphragmatic - hiatus -hernia, Diaphragmatic hiatus hernia, Hernia - diagphragmatic, hiatus hernia
French HERNIE HIATALE, Hernie diaphragmatique SAI, Hernie h, Hernie hiatale/diaphragmatique, Hernie hiatale (diagnostic), Hernie hiatale oesophagienne, Hernies diaphragmatiques, Hernie hiatale, Hernie diaphragmatique, Hernie du diaphragme
Italian Ernie diaframmatiche, Ernia diaframmatica NAS, Ernia diaframmatica/dello hiatus, Ernia iatale (diagnosi), Ernia jatale, Ernia jatale esofagea, Ernia diaframmatica, Ernia iatale
Dutch diafragmabreuk NAO, maagbreuk, Hernia diaphragmatica/hiatus, Hiatus hernia, diaphragmatica; hernia, hernia; diaphragmatica, hernia; hiatus, hiatus; hernia, diafragmabreuk, hiatus hernia, middenrifbreuk, Hernia diaphragmatica, Hernia hiatus oesophagei, Hiatushernia
German H Hernie, Diaphragmahernie NNB, Hiatushenie, HIATUSHERNIE, Zwerchfellhernie/Hiatushernie, Diaphragmahernie, Zwerchfellhernien, Hernia diaphragmatica, Hernie, Hiatus-, Hernie, Zwerchfell-, Hiatushernie, Zwerchfellhernie
Portuguese Hérnia diafragmática NE, HERNIA DO HIATO, Hernia do hiato/diafragmatica, Hérnia do Hiato, Hérnia de Hiato, Hérnia do diafragma, Hérnia do hiato, Hérnias diafragmáticas, Hérnia Diafragmática, Hérnia Hiatal
Spanish Hernia diafragmática NEOM, Hernia hiatal, Diaphragmatic hiatus hernia, Hernia - diagphragmatic, Diaphragmatic hernia, Diaphragmatic - hiatus -hernia, Hiatus hernia, Unspecified diaphragmatic hernia, HERNIA DE HIATO, Hernia de hiato/diafragmatica, Hernia de Hiato, Hiatus hernia NOS, Diaphragmatic hernia NOS, hernia de hiato, hernia diafragmática (trastorno), hernia diafragmática no especificada (trastorno), hernia diafragmática no especificada, hernia diafragmática, SAI (trastorno), hernia diafragmática, SAI, hernia diafragmática, hernia hiatal (trastorno), hernia hiatal esofágica, hernia hiatal, SAI (trastorno), hernia hiatal, SAI, hernia hiatal, Hernia de hiato, Hernia diafragmática, Hernias diafragmáticas, Hernia Diafragmática, Hernia Hiatal, Hernia Diafragmatica
Japanese 横隔膜ヘルニアＮＯＳ, 裂孔ヘルニア, ｵｳｶｸﾏｸﾍﾙﾆｱ, ﾚｯｺｳﾍﾙﾆｱ, ｵｳｶｸﾏｸﾍﾙﾆｱNOS, 横隔膜ヘルニア, ヘルニア-食道裂孔, 傍食道ヘルニア, ヘルニア-傍食道, 食道ヘルニア, ヘルニア-食道, 食道裂孔ヘルニア, 食道胃裂孔ヘルニア, ヘルニア-横隔膜
Swedish Diafragmabråck, Hiatusbråck, MELLANGARDSBRACK
Czech hernie brániční, hernie hiátová, Diafragmatická hernie NOS, Brániční kýly, Diafragmatická hernie, Hiátová kýla, Hiátová hernie
Finnish Palleatyrä, Hiatushernia, PALLEATYRA
Russian PISHCHEVODNAIA GRYZHA, DIAFRAGMAL'NAIA GRYZHA, KHIATAL'NAIA GRYZHA, PARAPISHCHEVODNAIA GRYZHA, GRYZHA DIAFRAGMAL'NAIA, PISHCHEVODNOGO OTVERSTIIA GRYZHA, GRYZHA PISHCHEVODNOGO OTVERSTIIA, ГРЫЖА ДИАФРАГМАЛЬНАЯ, ГРЫЖА ПИЩЕВОДНОГО ОТВЕРСТИЯ, ДИАФРАГМАЛЬНАЯ ГРЫЖА, ПАРАПИЩЕВОДНАЯ ГРЫЖА, ПИЩЕВОДНАЯ ГРЫЖА, ПИЩЕВОДНОГО ОТВЕРСТИЯ ГРЫЖА, ХИАТАЛЬНАЯ ГРЫЖА
Norwegian MELLOMGULVS-BROKK/HIATUS HERNIE
Danish Mellemgulvsbrok hiatushernie
Hungarian rekeszserv/hiatus hernia, Rekeszsérv, Rekesz sérv, Rekeszsérvek, Rekeszsérv k.m.n., H hernia
Korean 가로막헤르니아
Basque HERNIA HIATALA
Hebrew beka sarafti
Polish Przepuklina przeponowa, Przepuklina rozworu przełykowego
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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