CLINICOPATHOLOGICAL STUDIES ON THE ESOPHAGEAL HIATAL HERNIA IN THE AGED

Abstract

The purpose of this study was to estimate a clinical significance of esophageal hiatal hernia (HH). Subjects were 2, 845 cases examined for three years in upper GI tract by barium enema. Perhaps 20% of adults aged over 60 have HH and the incidence increased with advancing age. There was preference to female. The ratio of paraesophageal to sliding HH was considerably less than 3 vs 7. In the cases with the longer distance escaped from the diaphragm, clinical symptoms were present in about 50%. By histological examination of diaphragm, the 13 autopsied cases of HH often accompanied with atrophy and hyalin degeneration of muscle fibers more than the 14 autopsied cases of non-HH did. Microscopically, reflux esophagitis was detected in about 50% of HH. We would like to summarize;1) HH was common disorder in the aged, 2) HH escaped long from diaphragm had some significant symptoms, 3) The relaxation of adjacent tissues had probably played an important part in the pathogenesis of HH.