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14 Cards in this Set
- Front
- Back
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What are the two main types of hiatus hernias?
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Sliding and rolling hiatus hernias.
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What do the two different hiatus hernias look like?
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Sliding - Hiatus hernia where the gastroesophageal junction slides up into the chest dragging the upper stomach (gastric cardia) with it.
Rolling - Gastroesophageal junction remains in the abdomen but a bulge of part or all of proximal stomach herniates up into the chest alongside the esophagus |
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Most common type of hiatus hernia
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Sliding (95%)
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Rarest form of hiatus hernia
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Mixed sliding and rolling hiatus hernia
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Causes of sliding hiatus hernia
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1. Incr. intra-abdominal pressure (heavy lifting, pregnancy)
2. Muscle weakness of diaphragmatic opening that occurs with age 3. Hereditary weakness of diaphragm and esophagus 4. Chronic esophagitis (shortening of esophagus) |
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Causes of rolling hiatus hernia
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Cause uknown
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Risk factors for hiatus hernia
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Older
Women > Men Chronic constipation / low-fibre diet / rich Obesity |
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Symptoms of sliding hiatus hernia
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Often asymptomatic if small hernia
GERD symptoms |
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What can exacerbate symptoms of sliding hiatus hernia?
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Eating,
Lying down, NSAID use |
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Symptoms of rolling hiatus hernia
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Severe chest pain and vomiting due to volvulus and strangulation
Bleeding / ulceration Respiratory problems |
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Another name for rolling hiatus hernia
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paraesophageal hiatus hernia
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Investigations for hiatus hernia
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A. If large sliding hernia (>2cm):
Barium swallow Upper endoscopy Esophageal manometry CXR (incidental finding) B. If rolling hiatus hernia: barium swallow most sensitive |
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Tx for sliding hiatus hernia
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- if asymptomatic no tx needed
- if GERD - treat GERD - avoid: stooping, sleep flat, smoking, NSAIDS, spicy foods, alcohol, late night meals - PPI - Surgery if other tx not helping |
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Tx for rolling hiatus hernia
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Surgical intervention once discovered because the complications can be fatal
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