Incidence of Hiatal Hernias in the Current Endoscopic Praxis
Ténaiová J., Tůma L., Hrubant K., Brůha R., Švestka T., Novotný A., Petrtýl J., Jirásek V., Urbánek P., Lukáš K.Ténaiová J., Tůma L., Hrubant K., Brůha R., Švestka T., Novotný A., Petrtýl J., Jirásek V., Urbánek P., Lukáš K.
IV. interní klinika 1. LF UK a VFN – Gastroenterologické centrum, Praha
Background. Hiatal hernia represents penetration of the oral part of stomach together with the distal part
of oesophagus via oesophageal hiatus into the thoracic cavity. On the basis of endoscopic examination
hiatal hernia is defined as circular pull out of the gastric mucosa longer then 2 cm from the diaphragm
to Z line, measured at the end of examination during removing the endoscope. Hiatal hernia is usually
an acquired state which can worsen oesophagitis by holding refluxate and thus by prolonging the
duration of purgation.
Methods and Results. Endoscopic and radiological studies show that 50 to 94 % of patients with
gastroesophageal reflux disease have an axial hiatal hernia while in control persons the incidence
fluctuates between 13 % and 59 %. Hiatal hernia is a frequent finding during upper
gastrointestinal endoscopy. Hernia can contribute to the development of reflux into the proximal
oesophagus. A cohort of one thousand patients (18 to 94 years) who underwent upper
gastrointestinal endoscopy was analysed retrospectively. Endoscopy was performed between
January and June 2005 at the Endoscopic center of the 4th Medical Department of the University
Hospital in Prague.
Conclusions. Presented study has shown that in patients who underwent endoscopy, hiatal hernia occurs
in 16.6%, more frequently in men (53.6%). The most common type is an axial hiatal hernia with
incidence of 94.58%. In 50% of patients with hiatal hernia the reflux oesophagitis of various degrees was
hiatal hernia, reflux oesophagitis, gastroesophageal reflux disease.