CORRELATION BETWEEN VARICEAL HEMORRHAGE AND SMALL, SLIDING, ESOPHAGEAL HIATAL HERNIA

Abstract

Radiological and statistical studies were made on 98 patients with portal hypertension and 200 controls concerning the correlation between small, sliding, esophageal hiatal hernia (S. E. H. H.) and episode or history of variceal hemorrhage. The high incidence of S. E. H. H. was encountered in the patients with varices. Higher degrees (2nd. + 3rd.) of S. E. H. H. was highly associated with higher degrees (2nd. + 3rd.) of varices. In the group of higher degrees of S. E. H. H. with association of higher degrees of varices, hemorrhage was highly encountered. Many would not agree with the configuration of “first degree herniation of the gastroesophageal vestibule alone”, then this group was excluded from the final statistical conclusion although the hemorrhage was significant. In the group of controls the incidence of S. E. H. H. was significantly lower than in that of portal hypertension. Based on the present data it is most likely that the S. E. H. H. plays an important role in the development of variceal hemorrhage. Consequently it is mandatory to make a diagnosis of S. E. H. H. especially in the patients with varices for their treatment and the estimation of prognosis.