Accuracy of hiatal hernia detection with esophageal high‐resolution manometry

Abstract

With HRM, the presence or absence and size of a hiatal hernia can be assessed with greater sensitivity than with endoscopy or radiography alone.

Hiatus hernia in healthy volunteers is associated with intrasphincteric reflux and cardiac mucosal lengthening without traditional reflux

“…High-resolution manometry has been claimed to be useful in diagnosing hiatus hernia on the basis of demonstration of a double-peak pressure profile due to the separation of the intrinsic and extrinsic sphincter 19. In our subjects with hiatus hernia, the double-peaked pattern was observed intermittently and for <50% of the recording time and this was similar to the subjects who were negative for hiatus hernia by both MRI scan and endoscopy.…”

Prospective evaluation of surgical management of sliding hiatal hernia and gastroesophageal reflux in dogs

“…Only 26%‐50% of human patients with GERD confirmed via 24‐hour esophageal pH monitoring and/or pH‐impedance studies had evidence of GERD on videofluoroscopic swallow studies in 2 studies . High‐resolution manometry has been shown to be more sensitive and specific compared to videofluoroscopic swallow studies or endoscopy for diagnosis of SHH, but is not widely available to the veterinary community . The inherent limitations of videofluoroscopy should be recognized given the fact that SHH and GER are dynamic disorders that are intermittent in nature.…”

Variation in esophageal physiology testing in clinical practice: Results from an international survey

“…This further reduces standardization as results from upright and supine positions are not always identical, although it is very unusual for position to impact on diagnosis of major motility disorders. One area in particular, the diagnosis and quantification of hiatal hernia, varies widely, particularly in hernias of 3‐5 cm in length and greater, as inclusion/exclusion of the crural diaphragm and placement of the reference gastric pressure sensor within or below the hernia is not standardized …”