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March 1950


Arch Surg. 1950;60(3):633-634. doi:10.1001/archsurg.1950.01250010652016

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The following questions regarding esophageal hiatus hernia have been circularized and the replies summarized herein. It should be emphasized that there is not much discussion of the large diaphragmatic hernias, which in general offer little difficulty in diagnosis and treatment.

1. Is there any exception to the fact that roentgenologic examination after a barium swallow is the only means of objective anatomic diagnosis?

The roentgenologic examination after a barium swallow may miss the diagnosis in the case of small hernias and those which are particularly easily reducible, especially if views are not taken in the head-down position. If the patient is examined in the usual position, no evidence of herniation may be detected. Mention is also made of the use of the esophagoscope, and one reply emphasized its importance, particularly in determining the presence of other lesions which may be associated with the hernia as well as the presence of

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