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Hiatal hernia

Última revisión: 12 Sep 2025
Última actualización: 28 Jan 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • bowel sounds in chest
Todos los datos

Otros factores de diagnóstico

  • heartburn
  • regurgitation
  • obesity
  • chest pain
  • dysphagia
  • odynophagia
  • hematemesis
  • shortness of breath
  • cough
  • oropharyngitis
  • wheezing
  • nonbilious vomiting
  • fever and chills
  • confusion
Todos los datos

Factores de riesgo

  • obesity
  • increased age
  • previous gastroesophageal procedure
  • elevated intra-abdominal pressure
  • male sex
  • incisional, umbilical, or inguinal hernia
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • chest x-ray
  • upper gastrointestinal fluoroscopy with oral contrast
Todos los datos

Pruebas diagnósticas que deben considerarse

  • esophago-gastro-duodenoscopy
  • CT scan or MRI scan
  • high-resolution esophageal manometry and pH monitoring
Todos los datos

Algoritmo de tratamiento

Inicial

upper gastrointestinal hemorrhage and/or obstruction and/or volvulus

irreversible organ ischemia and/or necrosis

Agudo

symptomatic gastroesophageal reflux disease (GERD)

En curso

type I refractory to medical therapy or patient prefers surgery

types II, III, and IV

Colaboradores

Autores

Constantine T. Frantzides, MD, PhD, FACS
Constantine T. Frantzides

Director

Chicago Institute of Minimally Invasive Surgery

St. Francis Hospital

Clinical Professor of Surgery

University of Illinois Chicago

Chicago

IL

Divulgaciones

CTF declares that he has no competing interests.

Agradecimientos

Dr Constantine T. Frantzides would like to gratefully acknowledge Dr Mark A. Carlson, Dr Amy J. Hargrove and Dr Minh B. Luu, previous contributors to this topic.

Divulgaciones

MAC, AJH and MBL declare they have no competing interests.

Revisores por pares

Frank A. Granderath, MD

Associate Professor

Department of General, Visceral and Transplant Surgery

University Hospital Tuebingen

Germany

Divulgaciones

FAG declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Society of American Gastrointestinal and Endoscopic Surgeons. Guidelines for the management of hiatal hernia. Apr 2013 [internet publication].Texto completo

Roman S, Kahrilas PJ. The diagnosis and management of hiatus hernia. BMJ. 2014 Oct 23;349:g6154. Resumen

Sfara A, Dumitrascu DL. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep. 2019 Oct;92(4):321-25.Texto completo  Resumen

Antoniou SA, Müller-Stich BP, Antoniou GA, et al. Laparoscopic augmentation of the diaphragmatic hiatus with biologic mesh versus suture repair: a systematic review and meta-analysis. Langenbecks Arch Surg. 2015 Jul;400(5):577-83. Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

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