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A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
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Diverticular Disease of the Colon01:27

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Related Experiment Video

Updated: Jun 5, 2026

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
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Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse

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Parastomal hernia: clinical and radiological definitions.

A Jänes1, L Weisby, L A Israelsson

  • 1Department of Surgery, Kirurgkliniken, Sundsvalls Sjukhus, 851 86, Sundsvall, Sweden. arthur.janes@lvn.se

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|December 29, 2010
PubMed
Summary

A new clinical definition for parastomal hernia (a complication after stoma surgery) shows high correlation with CT scans. This suggests clinical examination alone is sufficient for follow-up, making traditional supine CT scans unreliable for diagnosis.

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Area of Science:

  • Abdominal Surgery
  • Surgical Complications
  • Diagnostic Imaging

Background:

  • Parastomal hernia is a common complication following stoma formation.
  • Previous studies lacked consistent definitions for parastomal hernia, leading to poor correlation between clinical examination and computed tomography (CT) scan findings.
  • A standardized clinical definition correlating with CT results is needed.

Purpose of the Study:

  • To develop and validate a reproducible clinical definition for parastomal hernia.
  • To assess the correlation between a new clinical definition and CT scan findings.
  • To determine the reliability of CT scans in diagnosing parastomal hernia.

Main Methods:

  • A new clinical definition of parastomal hernia was established: any protrusion near the stoma with patient straining (supine and erect).
  • A novel CT scan method involved examining patients in the prone position, defining herniation as intra-abdominal contents beyond the peritoneum or presence of a hernia sac.
  • Inter-rater reliability was assessed using Fleiss' Kappa values.

Main Results:

  • The new clinical definition demonstrated high reproducibility among surgeons (Kappa=0.85).
  • CT scans in the prone position showed high reproducibility among radiologists (Kappa=0.85) and strong correlation with clinical assessment (Kappa=0.80).
  • Conventional CT scans in the supine position showed lower correlation (Kappa=0.63).

Conclusions:

  • The new CT scan method in the prone position, alongside the revised clinical definition, offers high reproducibility and strong correlation between methods and raters.
  • Clinical examination alone is sufficient for follow-up of parastomal hernia due to its strong correlation with radiological findings.
  • Conventional supine CT scans are unreliable for diagnosing parastomal hernia.