Assessment of hiatus defect size in hiatal hernia patients using computed tomography
Methods: The multi-detector computed tomography images of 50 patients and 50 individuals in control group included in this study were investigated. The hiatus surface area (cm²), hiatus antero-posterior and transverse diameters (cm), and the thickness of both diaphragmatic crura (mm) were measured by reformatting contrast-enhanced thoraco-abdomino-pelvic computed tomography images using the region of interest method.
Results: In this study, a significant difference was obtained among groups according to hiatus surface area, hiatus antero-posterior, and transverse diameter measurements, and both left and right diaphragmatic crural thickness measurements (P<0.001). In the patient group, the cut-off values were determined by using ROC analysis, and the values above these cut-off values enabled a hernia diagnosis with high sensitivity and specificity.
Conclusions: Measuring the hiatus surface area on multi-detector computed tomography images could serve as a supplementary criterion for diagnosing of hiatal hernia.
1. Zheng Z, Liu X, Xin C, et al. A new technique for treating hiatal hernia with gastroesophageal reflux disease: the laparoscopic total left-side surgical approach. BMC Surg. 2021;21(1):361. doi: 10.1186/s12893-021-01356-3.
2. Watson TJ, Ziegler KM. The Pathogenesis of Hiatal Hernia. Foregut. 2022;2(1):36-43. doi:10.1177/26345161221083020.
3. Shamiyeh A, Szabo K, Granderath FA, Syré G, Wayand W, Zehetner J. The esophageal hiatus: what is the normal size? Surg Endosc. 2010;24(5):988-991. doi: 10.1007/s00464-009-0711-0.
4. Moten AS, Ouyang W, Hava S, et al. In vivo measurement of esophageal hiatus surface area using MDCT: description of the methodology and clinical validation. Abdom Radiol (NY). 2020;45(9):2656-2662. doi: 10.1007/s00261-019-02279-7.
5. Boru CE, Rengo M, Iossa A, et al. Hiatal Surface Area's CT scan measurement is useful in hiatal hernia's treatment of bariatric patients. Minim Invasive Ther Allied Technol. 2021;30(2):86-93. doi: 10.1080/13645706.2019.1683033.
6. Ouyang W, Dass C, Zhao H, Kim C, Criner G; COPDGene Investigators. Multiplanar MDCT measurement of esophageal hiatus surface area: association with hiatal hernia and GERD. Surg Endosc. 2016;30(6):2465-2472. doi: 10.1007/s00464-015-4499-9.
7. Kumar D, Zifan A, Ghahremani G, Kunkel DC, Horgan S, Mittal RK. Morphology of the Esophageal Hiatus: Is It Different in 3 Types of Hiatus Hernias? J Neurogastroenterol Motil. 2020;26(1):51-60. doi: 10.5056/jnm18208.
8. Sfara A, Dumitrascu DL. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep. 2019;92(4):321-325. doi: 10.15386/mpr-1323.
9. Batirel HF, Uygur-Bayramicli O, Giral A, et al. The size of the esophageal hiatus in gastroesophageal reflux pathophysiology: outcome of intraoperative measurements. J Gastrointest Surg. 2010;14(1):38-44. doi: 10.1007/s11605-009-1047-8.
10. Franzén T, Tibbling L. Is the severity of gastroesophageal reflux dependent on hiatus hernia size? World J Gastroenterol. 2014;20(6):1582-1584. doi: 10.3748/wjg.v20.i6.1582.
11. Kahrilas PJ. GERD pathogenesis, pathophysiology, and clinical manifestations. Cleve Clin J Med. 2003;70 Suppl 5:S4-19. doi: 10.3949/ccjm.70.suppl_5.s4.
12. Vandenplas Y, Hassall E. Mechanisms of gastroesophageal reflux and gastroesophageal reflux disease. J Pediatr Gastroenterol Nutr. 2002;35(2):119-136. doi: 10.1097/00005176-200208000-00005.
Copyright (c) 2024 The European Research Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Downloads
Article Information
- Article Type Research Article
- Submitted February 21, 2026
- Published May 3, 2024
- Issue Vol. 10 No. 3 (2024)
- Section Research Article
