Imaging

Hiatal Hernia

Preliminary Diagnosis: Hiatal Hernia

I. What imaging technique is first-line for this diagnosis

  • Fluoroscopic guided barium study (esophagram or upper GI)

II. Describe the advantages and disadvantages of this technique for diagnosis of an hiatal hernia.

Advantages

  • Barium esophagram and upper GI tests are minimally invasive and generally well tolerated.

  • Degree of hiatal hernia can be assessed and associated ulcers may be discovered.

Disadvantages

  • Exposure to ionizing radiation

III. What are the contraindications for the first-line imaging technique?

  • Pregnancy may be a relative contraindication, although the fetus is not within the direct radiation beam.

IV. What alternative imaging techniques are available?

  • CT (with oral contrast)

  • Radiography (plain film)

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of an hiatal hernia.

CT (with oral contrast)

Advantages

  • CT will demonstrate widening of the diaphragmatic cura.

  • Severity of hiatal and paraesophageal hernias, as well as contents and orientation of the stomach are well demonstrated with CT.

Disadvantages

  • Exposure to ionizing radiation

Plain film

Advantages

  • Hiatal hernias may be incidentally identified on chest radiographs in the retrocardiac region.

Disadvantages

  • Plain film imaging is limited for small hiatal hernias.

  • Hiatal hernia is often an incidental finding and further workup with endoscopy or fluoroscopy is indicated.

VI. What are the contraindications for the alternative imaging techniques?

CT (with oral contrast)

  • Contraindicated in a pregnant patient, especially within the first two trimesters

Plain radiographs

  • No significant contraindications exist.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters