If your doctor believes that your hernia may have developed a complication — such as becoming trapped or having its blood supply cut off — then you may undergo imaging tests as well as blood tests to look for signs of infection.
By subscribing you agree to the Terms of Use and Privacy Policy. Health Topics. Health Tools. Reviewed: April 20, Medically Reviewed. There are several types of hernias, each of which is associated with its own set of symptoms. Editorial Sources and Fact-Checking. Cleveland Clinic. June 16, Inguinal Hernia. Mayo Clinic. January 6, Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Request an Appointment at Mayo Clinic.
Share on: Facebook Twitter. Show references Sfara A, et al. The management of hiatal hernia: An update on diagnosis and treatment. Medicine and Pharmacy Reports. Ferri FF. Hiatal hernia. In: Ferri's Clinical Advisor Elsevier; Accessed Nov. Kliegman RM, et al. In: Nelson Textbook of Pediatrics. Goldman L, et al.
Diseases of the esophagus. In: Goldman-Cecil Medicine. Feldman M, et al. Gastroesophageal reflux disease. Hiatal hernia HH is defined as a herniation of the abdominal organs into the chest through the oesophageal diaphragmatic hiatus [ 3 ].
This is a well-recognized anomaly in children but most reported cases refer to adult patients. Its etiology is not precisely known, but the hypothesis of its congenital origin is widely accepted. Similarly to other congenital diaphragmatic defects, HH follows a sporadic pattern of incidence in most cases.
Familial occurrence of sliding HH has been reported in more than 20 cases, but only one family with two members affected has been described in the literature. The presence of HH in the newborn should alert the clinician to suspect connective tissue disorders such as Ehlers-Danlos syndrome, cutis laxa, and Marfan syndrome [ 6 ].
Hiatal hernia often involves parts of the stomach and rarely other abdominal viscera and it is generally classified by the position of the gastroesophageal junction relative to the diaphragm.
The gastroesophageal junction is a complex valve composed of a smooth muscle element and a diaphragmatic element. These normally supplement each other to maintain competence in a static condition and during dynamic stress associated with increased intraabdominal pressure [ 7 ]. Prenatal diagnosis of HH is unusual and to our knowledge only eight cases have been reported in the literature [ 1 — 5 ].
In all reported cases of CHH, the condition was identified in the third trimester of gestation. This late onset may be due to the fact that the fetus may be unable to develop sufficient pressure to dilate the intrathoracic stomach until the third trimester. In the majority of the reports, CHH was an isolated anomaly [ 1 , 3 , 4 ].
However, Yamamoto et al. In this fetus, the stomach was observed as intermittently herniating into the thoracic cavity. An intermittent gastric herniation was also described by Ogunyemi in a case of CHH associated with polyhydramnios; in this case the presence of hydramnios was probably due to esophageal reflux correlated with stomach obstruction and the differential diagnosis with esophageal atresia was made by the authors [ 1 ].
In three cases, including ours, the stomach was normally seen in the abdomen, while in three other fetuses the stomach was completely herniated into the chest and no intraabdominal stomach was visible; one of these fetuses was affected by CHARGE syndrome [ 2 ].
The presence of a cystic mass in the fetal thorax should alert the sonographer to consider in the differential diagnosis congenital chest anomalies such as diaphragmatic hernia, macrocystic adenomatoid malformation of the lung, or rarer conditions such as esophageal duplication or neurenteric cyst [ 4 ].
The sonographic criteria for the prenatal diagnosis of CHH were first proposed by Bahado-Singh et al. The criteria suggested are helpful for making the correct diagnosis and are as follows: 1 the presence of a hypoanechoic mass in the posterior mediastinum, just behind the heart and anterior to the vertebral body, corresponds to a herniated stomach; 2 there is neither mediastinal shift nor pleural or pericardial effusion; the stomach can be identified in the abdominal cavity but in a median position or is not visible in the abdomen because of its complete herniation into the fetal thorax; 3 the dynamic aspect of the herniated stomach means its up—down movements through the enlarged hiatal into the thoracic cavity.
Although congenital hiatal hernia is never a critical condition, it cannot be considered entirely free from significant morbidity. CHH does not carry the same risks as those seen in adult cases.
Materials and methods: This retrospective study was performed in the radiology department of a tertiary care center between May and May Twenty-one patients 10 females, 11 males with sliding hiatal hernias and 41 controls 37 females, 4 males were enrolled in this study.
Esophageal hiatal diameters measured by ultrasonography and computerized tomography were compared. Correlation was tested via Pearson correlation analysis.
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