When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Hiatal hernia

Последний просмотренный: 16 Aug 2025
Last updated: 28 Jan 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • bowel sounds in chest
Полная информация

Другие диагностические факторы

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

Факторы риска

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

Диагностические исследования

Исследования, которые показаны в первую очередь

  • chest x-ray
  • upper gastrointestinal fluoroscopy with oral contrast
Полная информация

Исследования, проведение которых нужно рассмотреть

  • esophago-gastro-duodenoscopy
  • CT scan or MRI scan
  • high-resolution esophageal manometry and pH monitoring
Полная информация

Алгоритм лечения

Начальные

upper gastrointestinal hemorrhage and/or obstruction and/or volvulus

irreversible organ ischemia and/or necrosis

Острый

symptomatic gastroesophageal reflux disease (GERD)

ПРОДОЛЖЕНИЕ

type I refractory to medical therapy or patient prefers surgery

types II, III, and IV

Составители

Авторы

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

Раскрытие информации

CTF declares that he has no competing interests.

Выражение благодарностей

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.

Раскрытие информации

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

Рецензенты

Frank A. Granderath, MD

Associate Professor

Department of General, Visceral and Transplant Surgery

University Hospital Tuebingen

Germany

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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

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

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

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. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Использование этого контента попадает под действие нашего заявления об отказе от ответственности