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Assessment of the Gastrointestinal System I: Subjective Data01:17

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
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Assessment of the Rectum and Anus01:25

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Types of Reports II: Incident or Occurrence Report01:21

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An Incident or Occurrence Report in a healthcare setting is a crucial document used to record any unexpected occurrence that may or may not have affected a patient, employee, or visitor. Such reports are critical to improving patient safety and include all details leading up to and including the event.
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Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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Hiatal hernia reporting: time to remove subjectivity?

Deanna L Palenzuela1, Denise Gee2, Emil Petrusa2

  • 1Massachusetts General Hospital, Boston, MA, USA. dpalenzuela@mgh.harvard.edu.

Surgical Endoscopy
|November 20, 2023
PubMed
Summary
This summary is machine-generated.

Objective axial length measurements and subjective size estimates for hiatal hernias (HH) correlate with manometry findings and surgical decisions. Including axial length in endoscopy reports may improve patient outcomes.

Keywords:
Barium swallowEndoscopyHernia defect sizeHiatal herniaHiatal hernia repairManometry

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Hiatal hernia (HH) size is crucial for surgical repair approach.
  • Endoscopic size assessments often lack objective standardization, using subjective terms like 'small,' 'medium,' or 'large.'
  • Objective measurements are needed to correlate with diagnostic and surgical data.

Purpose of the Study:

  • To compare objective axial length measurements of hiatal hernias (HHs) with subjective size allocations.
  • To correlate endoscopic measurements with manometry and barium swallow study findings.
  • To evaluate the utility of objective and subjective HH size assessments in clinical decision-making.

Main Methods:

  • Retrospective review of 93 patients with endoscopically diagnosed HHs.
  • Collected data included subjective HH size, objective axial length (cm), manometry, and barium swallow results.
  • Linear and ordered logistic regression models analyzed correlations between measurements.

Main Results:

  • Axial length measurements and endoscopic subjective size estimates significantly correlated with manometry findings.
  • Barium swallow subjective size estimates showed no significant correlation with endoscopic or manometry measurements.
  • Mesh placement correlated significantly with pre-operative endoscopic axial length and subjective size estimates.

Conclusions:

  • Both endoscopic subjective size allocations and objective axial length measurements are associated with pre-operative data and intra-operative decisions.
  • Objective axial length measurements in endoscopy reports can enhance outcome reporting and guide clinical decisions.
  • Standardized objective measurements are valuable for hiatal hernia management.