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June 1959

Balanced Operations for Esophagitis Associated with Esophageal Hiatal Hernia

Author Affiliations

From the Departments of Surgery, Indianapolis General and Methodist Hospitals.

AMA Arch Surg. 1959;78(6):889-896. doi:10.1001/archsurg.1959.04320060077010

The literature on esophageal hiatal hernia associated with esophagitis is voluminous. However, in reviewing the many early and recent articles on the subject, we have found that there is great confusion in nomenclature and very little consideration of the commonly associated lesions. There is also great variation in the methods of surgical treatment with equally variable results. This discussion concerns itself primarily with esophageal hiatal hernia, commonly known as the sliding or so-called short esophageal type.

Nomenclature and Pathogenesis  We shall use the term esophageal hiatus hernia to describe the so-called sliding or short esophageal type, and we define this as a cephalad displacement of the cardia of the stomach above the diaphragm (Figure, 1A). We have previously stated4 that this particular type of hernia is primarily a malfunction of several of the derivatives of the foregut, the parts of the alimentary canal nourished mainly by blood from