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Achalasia and hiatal hernia.

S P Goldenberg1, C Vos, M Burrell

  • 1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06510.

Digestive Diseases and Sciences
|April 1, 1992
PubMed
Summary

Hiatal hernia is not rare in patients with achalasia, contrary to previous reports. This common condition is often unrecognized in achalasia patients, suggesting a need for better diagnostic awareness.

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Area of Science:

  • Gastroenterology
  • Radiology

Background:

  • Hiatal hernia is common in the general population.
  • Reports suggest hiatal hernia is rare in achalasia patients.
  • Achalasia and hiatal hernia are not inherently incompatible.

Purpose of the Study:

  • To determine the actual frequency of hiatal hernia in achalasia patients.
  • To assess the recognition of hiatal hernia in achalasia cases.

Main Methods:

  • Retrospective review of radiographs from 71 achalasia patients.
  • Analysis of radiographic reports for co-occurring hiatal hernia.
  • Evaluation of treatment outcomes for patients with both conditions.

Main Results:

  • Hiatal hernia was identified in 14.1% of achalasia patients.
  • The prevalence was higher (25.7%) in patients aged 51 and older.
  • Only two of ten identified cases were correctly reported.

Conclusions:

  • Hiatal hernia is frequently underreported and unrecognized in achalasia.
  • The prevalence of hiatal hernia in achalasia is likely similar to the general population.
  • Pneumatic dilatation showed excellent results in patients with both conditions.

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