No abstract

No abstract

It has been suggested (Casten, Bernhang, Nach, and Spinzia, 1963) that patients with symptomatic sliding hiatus hernia have a higher acid output than the normal patient, but this has recently been disputed by Williams, Lawrie, and Forrest (1967). These latter workers found that there is no significant increase in maximal acid output in patients with sliding hiatus hernia. Aylwin (1953) demonstrated a correlation between the degree of oesophagitis in sliding hiatus hernia and the enzyme activity of juices bathing the oesophagus at night, and suggested that this was the chief factor in the production of oesophagitis. In this study patients with hiatus hernia were investigated to see if there was any correlation between the degree of oesophagitis and the maximal acid output. The maximal acid output in patients with hiatus hernia was found not to differ significantly from normal, and the degree of oesophagitis in the patients with oesophageal reflux was not closely related to the maximal acid output. MATERIALFifty-seven patients admitted for surgical repair of symptomatic hiatus hernia were studied. All patients had pre-operative barium studies to detect gastrooesophageal reflux, oesophageal stricture, and gastric or duodenal ulceration. Oesophagoscopy was also carried out in every case to determine the presence and degree of oesophagitis.Of the 57 patients, 21 were men and 36 were women, with an age range from 33 to 77 years. Fifty patients had sliding hiatus herniae; seven of these had strictures and one had a Schatzki's ring. Six patients had paraoesophageal herniae and one patient had oesophageal reflux without demonstrable hiatus hernia.In the series seven patients were known to have had duodenal ulceration, six of whom had sliding hiatus herniae and one of whom had a paraoesophageal hernia. In all patients a thoraco-abdominal approach was used for repair of the hiatus hernia, and no evidence of duodenal ulceration was found in any other patient on direct examination of the duodenum.

No abstract

No abstract