Abstract IN THE evaluation of the clinical significance of the esophageal hiatus hernia, the question of how frequently this lesion exists without symptoms assumes considerable importance. In view of the increasing incidence in the diagnosis of hiatus hernia, largely due to more frequent routine use of various positional maneuvers of the patient during the roentgenologic examination of the upper gastrointestinal tract, the problem of asymptomatic hiatus hernia is of greater interest. For instance, in a recent study1 hiatus hernia was the second most frequent diagnosis made for 3,448 patients undergoing roentgenologic study of the upper gastrointestinal tract after a barium meal. Duodenal ulcer was diagnosed in 705 patients while hiatus hernia was present in 308 patients. There is great variance of opinion in the literature as to the importance and incidence of asymptomatic patients with hiatus hernia. In most reports the authors present various features of the clinical picture References 1. Brick, I. B.: Clinical Significance of Hiatus Hernia , Mississippi Valley M. J. 71:2, 1949. 2. Shanks, S. C.: Hiatus Hernia , Brit. J. Radiol. 21:55, 1948.Crossref 3. Wilkinson, S. A.: Diaphragmatic Hernia , New England J. Med. 210:1105, 1934.Crossref 4. Moersch, H. J.: Hiatal Hernia , Ann. Otol., Rhin. & Laryng. 47:754, 1938. 5. Ritvo, M.: Hernia of the Stomach Through the Esophageal Orifice of the Diaphragm , J. A. M. A. 94:15 ( (Jan. 4) ) 1930. 6. Ohler, W. R., and Ritvo, M.: Diaphragmatic (Hiatus) Hernia , New England J. Med. 229:191, 1943. 7. Jones, C. M.: Hiatal Esophageal Hernia , New England J. Med. 225:965, 1941. 8. Root, J. C., and Pritchett, C. P.: Diaphragmatic Hernia , Cleveland Clin. Quart. 5:203, 1938. 9. Radloff, F. F., and King, R. L.: Esophageal Hiatus Hernia , Gastroenterology 9:249, 1947. 10. Brick, I. B.: Incidence of Hiatus Hernia and Associated Lesions Diagnosed by Roentgen Ray , Arch. Surg. 58:419 ( (April) ) 1949. 11. Harrington, S. W.: Esophageal Hiatal Hernias of the Short Esophageal Type: Etiologic and Therapeutic Considerations , J. Thoracic Surg. 17:189, 1948. 12. Master, A. M.; Dack, S.; Stone, J., and Grishman, A.: Differential Diagnosis of Hiatus Hernia and Coronary Artery Disease , Arch. Surg. 58:428 ( (April) ) 1949. 13. Sherman, R. S.: Roentgenoscopic Survey for Asymptomatic Gastric Cancer , J. Am. M. Women's A. 3:136, 1948. 14. Rigler, L. G.: Roentgen Examination of the Stomach in Symptomless Persons , J. A. M. A. 137:1501 ( (Aug. 21) ) 1948. 15. St. John, F. B.; Swenson, P. C., and Harvey, H. D.: An Experiment in the Early Diagnosis of Gastric Carcinoma , Ann. Surg. 119:225, 1944. 16. Major Armen Bogosian, M. C., United States Soldiers' Home , Washington, D. C., cooperated splendidly in this study. 17. Nuzum, F. R.: Hernia of Esophageal Hiatus: Its Relationship to Angina Pectoris , Am. Heart J. 33:724, 1947. 18. Gilbert, N. C.: Recurrent Esophageal Hiatus Hernia , M. Clin. North America 32:213, 1948.
Archives of Surgery – American Medical Association
Published: Jun 1, 1950