Gastroenterology Book

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Diaphragmatic HerniaAka: 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
  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. Radiology
    1. Barium swallow (UGI)
      1. Stomach herniated above diaphragm

Diaphragmatic Hernia (C0019284)

Definition (MSH)Protrusion of abdominal structures into the THORAX as a result of congenital or traumatic defects in the respiratory DIAPHRAGM.
ConceptsAnatomical Abnormality (T190)
MSHD006548
EnglishDIAPHRAGMATIC HERNIA, Diaphragmatic Hernias, Hernia - diagphragmatic, Unspecified diaphragmatic hernia
Spanishhernia diafragmatica, hernia diafragmatica no especificada
Parent ConceptsHernia of abdominal cavity (C0178282), Hernia (C0019270), Esophageal Diseases (C0014852), Diaphragmatic Hernia (C0019284), Defect of diaphragm (C0239179), Duplicate concept (C1274013)
SourcesAOD, CCS, COSTAR, DXP, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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