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December 12, 1966

Hiatal Hernia's Hidden Clues

JAMA. 1966;198(11):39. doi:10.1001/jama.1966.03110240013004

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Intraluminal manometry can detect hiatal hernia in the 10% to 15% of cases where symptoms of esophagitis persist and x-rays show no evidence of hiatal hernia.

The diagnostic procedure was described in the exhibit which won the annual Hull award presented at the Clinical Convention for the best exhibit on original medical research or instruction.

Prepared by the Louisiana State University School of Medicine, the exhibit describes the pathogenesis and pathology of inflammatory esophageal changes. Diagnostic aids such as fluorocinematography and endoscopy are depicted in motion pictures. Also illustrated are medical and surgical treatments.

In diagnosis, the Louisiana team has been using intraluminal manometry with the Modified Bernstein Test before undertaking esophagoscopy. "After working with these techniques some more," says Richard Vela, PhD, assistant professor of surgery, "we may find that it will not be necessary to subject a patient to esophagoscopy unless malignancy rather than esophagitis is suspected."