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Erschienen in: Journal of Gastroenterology 6/2018

26.10.2017 | Original Article—Alimentary Tract

Endoscopic diagnosis of hiatus hernia under deep inspiration is not consistent with esophageal manometric diagnosis

verfasst von: Yuriko Hanada, Shintaro Hoshino, Yoshimasa Hoshikawa, Nana Takenouchi, Mariko Umezawa, Noriyuki Kawami, Katsuhiko Iwakiri

Erschienen in: Journal of Gastroenterology | Ausgabe 6/2018

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Abstract

Background

To investigate the relationship between endoscopic and esophageal manometric hiatus hernia (HH).

Methods

Forty-six gastroesophageal reflux disease patients with endoscopic HH under maintenance therapy were recruited. Endoscopy was performed on all patients in a fully conscious state. Endoscopic HH was defined as apparent separation greater than 1 cm of the lower margin of the esophageal palisade vessels and the diaphragm hiatus on endoscopy under deep inspiration. Esophageal manometry was conducted using high-resolution manometry (HRM). The length between the lower margin of the lower esophageal sphincter and pulmonary inversion point was measured 10 times. The mean and maximum of the length was then calculated.

Results

The mean HH length on HRM was 0 cm (0–0) [median (25th to 75th percentile)], 0 cm (0-0), 0.5 cm (0–1.1), and 2.2 cm (1.3–2.5) in the groups with endoscopic HH lengths of 1–2, 2–3, 3–4, and 4–5 cm, respectively. The maximum HH length on HRM was 0 cm (0–0), 0 cm (0–0), 0.8 cm (0–1.4), and 2.4 cm (1.5–2.9) in the 1–2, 2–3, 3–4, and 4–5 cm endoscopic HH groups, respectively. The mean and maximum HH lengths increased significantly in the group with an endoscopic HH length of 4–5 cm compared with the other groups, but did not differ significantly among the 1–2, 2–3, and 3–4 cm groups. Of patients with endoscopic HH less than 3 cm, few had esophageal manometric HH greater than 2 cm.

Conclusions

Endoscopic diagnosis of HH under deep inspiration is not consistent with esophageal manometric diagnosis, leading to overdiagnosis.
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Metadaten
Titel
Endoscopic diagnosis of hiatus hernia under deep inspiration is not consistent with esophageal manometric diagnosis
verfasst von
Yuriko Hanada
Shintaro Hoshino
Yoshimasa Hoshikawa
Nana Takenouchi
Mariko Umezawa
Noriyuki Kawami
Katsuhiko Iwakiri
Publikationsdatum
26.10.2017
Verlag
Springer Japan
Erschienen in
Journal of Gastroenterology / Ausgabe 6/2018
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-017-1403-5

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