October 1957

Esophageal Hiatal Hernia a Manifestation of Peptic EsophagitisTreatment by Gastric Surgery

AMA Arch Surg. 1957;75(4):660-673. doi:10.1001/archsurg.1957.01280160170021

Esophageal hiatal hernia is a common disease of adults, with associated symptoms which are sometimes disabling and complications which are sometimes fatal.3 The indications for therapy and the type of treatment in the individual case are controversial. Indeed, the etiology of the condition is essentially unknown. There are unexplained discrepancies concerning esophageal hiatal hernia which must be defined to secure an accurate concept of the disease. When Wangensteen, in 1939, resected a stomach for a duodenal ulcer and effected a cure in an associated stenosing esophagitis, he established gastric resection as an effective treatment for peptic esophagitis.22 Sufficient emphasis has not subsequently been given this observation. Controversy has centered about the best approach to the mechanical repair of a presumably important enlarged esophageal hiatus.1,12 Yet, in the presence of herniation of the esophagogastric junction into the chest, the hiatus is often found to be normal in size,

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