What tests should be done for esophageal hiatus hernia?
Since esophageal hiatal hernia is relatively rare and has no specific signs and symptoms, it is difficult to diagnose.
Other auxiliary examinations.
1.X-ray is still the main method to diagnose hiatal hernia. For reducible hiatal hernia (especially mild), a negative examination cannot exclude the disease.
(1) Direct signs.
① supradiaphragmatic hernia sac.
(ii) elevation and contraction of the lower esophageal sphincter ring (A ring).
(iii) coarse and tortuous gastric mucosal folds in the hernia sac.
(iv) appearance of the esophagogastric ring (B ring).
(v) Esophageal bursal hiatal hernia may be seen with a hernia sac (gastric sac) on one side of the esophagus while the esophago-gastric junction remains under the diaphragmatic foramen.
(6) The mixed type may have a giant hernia sac or gastric axis torsion.
(2) Indirect signs.
(i) Widening of the diaphragmatic esophageal foramen (>4 cm).
(ii) regurgitation of barium into the supradiaphragmatic hernia sac.
(3) Shortening of the concave ring esophagus at least 3cm away from the diaphragm.
The diagnostic rate of endoscopy for esophageal hiatal hernia is improved compared with that of the previous examination.
(1) elevation of the dentate line of the lower esophagus.
(2) Retained fluid in the lumen of the esophagus.
(3) Enlargement and/or relaxation of the cardia opening.
(4) Blunting of the His angle.
(5) Altered line of the gastric fundus.
(6) wide and flaccid diaphragmatic esophageal fissure.
Esophageal manometry may have abnormal patterns in esophageal hiatal hernia, thus assisting in the diagnosis of abnormal esophageal manometry patterns mainly in the following manifestations.
(1) Double pressure bands on lower esophageal sphincter (LES) manometry.
(2) Lower esophageal sphincter pressure (LESP) decreases below normal values.