Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- bowel sounds in chest
Otros factores de diagnóstico
- heartburn
- regurgitation
- obesity
- chest pain
- dysphagia
- odynophagia
- hematemesis
- shortness of breath
- cough
- oropharyngitis
- wheezing
- nonbilious vomiting
- fever and chills
- confusion
Factores de riesgo
- obesity
- increased age
- previous gastroesophageal procedure
- elevated intra-abdominal pressure
- male sex
- incisional, umbilical, or inguinal hernia
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- chest x-ray
- upper gastrointestinal fluoroscopy with oral contrast
Pruebas diagnósticas que deben considerarse
- esophago-gastro-duodenoscopy
- CT scan or MRI scan
- high-resolution esophageal manometry and pH monitoring
Algoritmo de tratamiento
upper gastrointestinal hemorrhage and/or obstruction and/or volvulus
irreversible organ ischemia and/or necrosis
symptomatic gastroesophageal reflux disease (GERD)
type I refractory to medical therapy or patient prefers surgery
types II, III, and IV
Colaboradores
Autores
Constantine T. Frantzides, MD, PhD, FACS

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
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.
Diferenciales
- Angina pectoris
- Gastroesophageal reflux disease (GERD)
- Pneumonia
Más DiferencialesGuías de práctica clínica
- Guidelines for the surgical treatment of hiatal hernias
- ACR appropriateness criteria: epigastric pain
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