Hiatus Hernia. El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy
Sliding Hiatal Hernia. Esophageal mucosa in the foreground, gastric mucosa in the background. A hiatal hernia occurs when a portion of the stomach prolapses through the diaphragmatic esophageal hiatus. Although the existence of hiatal hernia has been described in earlier medical literature, it has come under close scrutiny only in the last century or so because of its association with gastroesophageal reflux disease (GERD) and its complications. By far, the majority of hiatal hernias are asymptomatic and are discovered incidentally. On rare occasion, a life-threatening complication, such as gastric volvulus or strangulation, may present acutely.

Sliding Hiatal Hernia.

 Esophageal mucosa in the foreground, gastric mucosa in
 the background.

 A hiatal hernia occurs when a portion of the stomach
 prolapses through the diaphragmatic esophageal hiatus.
 Although the existence of hiatal hernia has been described in
 earlier medical literature, it has come under close scrutiny
 only in the last century or so because of its association with
 gastroesophageal reflux disease (GERD) and its
 complications. By far, the majority of hiatal hernias are
 asymptomatic and are discovered incidentally. On rare
 occasion, a life-threatening complication, such as gastric
 volvulus or strangulation, may present acutely.

 For further endoscopic information, download the video clip
 by clicking on the endoscopic image. Wait to be
 downloaded complete then Press Alt and Enter for full
 screen ( Windows Media), Real Player: Ctrl and 3.
 All endoscopic images shown in this Atlas contain
 video clips. We recommend seeing the video clips in full
 screen mode.

Superior Esophagic Sphincter. The video clip displays a complete retroflexed maneuver from the cardias to the upper esophagic sphincter, the video clip also shows a big hiatal hernia with reflux esophagitis.

Video Endoscopic Sequence 1 of 2.

 Superior Esophagic Sphincter.

 The video clip displays a complete retroflexed maneuver
 from the cardias to the upper esophagic sphincter, the
 video clip also shows a big hiatal hernia with reflux
 esophagitis.
 An endoscopist must be sure to diagnose a hiatal hernia in
 the absence of vomiting and coughs, because it may give a
 false positive diagnosis of hiatal hernia.

 
          
Hiatal Hernia retroflexed view. The video clip shows a retroflexed endoscopic maneuver all the way until the upper esophagic sphincter.

Video Endoscopic Sequence 2 of 2. 

Hiatal Hernia retroflexed view.

 The video clip shows a retroflexed endoscopic maneuver
 all the way until the upper esophagic sphincter.
  
 

A hiatal hernia occurs when a portion of the stomach prolapses through the diaphragmatic esophageal hiatus. Although the existence of hiatal hernia has been described in earlier medical literature, it has come under scrutiny only in the last century or so because of its association with gastroesophageal reflux disease (GERD) and its complications. By far, most hiatal hernias are asymptomatic and are discovered incidentally. On rare occasion, a life-threatening complication, such as gastric volvulus or strangulation, may present acutely.

Video Endoscopic Sequence 1 of 3.

Hiatus Hernia

 A hiatal hernia occurs when a portion of the stomach
 prolapses through the diaphragmatic esophageal hiatus.
 Although the existence of hiatal hernia has been described
 in earlier medical literature, it has come under scrutiny
 only in the last century or so because of its association with
 gastroesophageal reflux disease (GERD) and its
 complications. By far, most hiatal hernias are
 asymptomatic and are discovered incidentally. On rare
 occasion, a life-threatening complication, such as gastric
 volvulus or strangulation, may present acutely.
The esophagus passes through the diaphragmatic hiatus in the crural part of the diaphragm to reach the stomach. The diaphragmatic hiatus itself is approximately 2 cm in length and chiefly consists of musculotendinous slips of the right and left diaphragmatic crura arising from either side of the spine and passing around the esophagus before inserting into the central tendon of the diaphragm. The size of the hiatus is not fixed, but narrows whenever intra-abdominal pressure rises, such as when lifting weights or coughing.

Video Endoscopic Sequence 2 of 3.

Hiatus Hernia

 The esophagus passes through the diaphragmatic hiatus in
 the crural part of the diaphragm to reach the stomach. The
 diaphragmatic hiatus itself is approximately 2 cm in length
 and chiefly consists of musculotendinous slips of the right
 and left diaphragmatic crura arising from either side of the
 spine and passing around the esophagus before inserting
 into the central tendon of the diaphragm. The size of the
 hiatus is not fixed, but narrows whenever intra-abdominal
 pressure rises, such as when lifting weights or coughing.

 
Hiatus Hernia.

Video Endoscopic Sequence 3 of 3.

Hiatus Hernia
Hiatus Hernia with Schatzki Ring. A 40 year-old female with intermittent dysphagia to solids. Esophageal rings were described by Schatzki as mucosal structures at the gastroesophageal junction that are smooth, thin (<4 mm in axial length), and covered with squamous mucosa above and columnar epithelium below.

Hiatus Hernia with Schatzki Ring.

 A 40 year-old female with intermittent dysphagia to solids.
 
 Esophageal rings were described by Schatzki as mucosal
 structures at the gastroesophageal junction that are
 smooth, thin (<4 mm in axial length), and covered with
 squamous mucosa above and columnar epithelium below.

 Medline: Analysis of thirty-two patients with Schatzki's ring.

      
Esophagus Schatzki Ring. A typical appearing uniform and weblike Schatzki mucosal ring. The cause of lower esophageal rings is still a matter of debate.

Video Endoscopic Sequence 1 of 3.

Esophagus Schatzki Ring.

 A typical appearing uniform and weblike Schatzki mucosal
 ring.
 The cause of lower esophageal rings is still a matter of
 debate.

 



                                          Medline.
Schatzki Ring retroflexed view. Lower Esophageal (Schatzki) Ring. The lower esophageal ring, also known as a Schatzki or mucosal Bring, is located at the squamocolumnar junction with a hiatal hernia. This is a thin mucosal membrane or diaphragm-like ring usually no more than 2-3 mm thick.

Video Endoscopic Sequence 2 of 3.

Schatzki Ring retroflexed view.

           Lower Esophageal (Schatzki) Ring.
 The lower esophageal ring, also known as a Schatzki or
 mucosal Bring, is located at the squamocolumnar junction
 with a hiatal hernia. This is a thin mucosal membrane or
 diaphragm-like ring usually no more than 2-3 mm thick.

                                           Medline.
 
Lower Esophageal (Schatzki) Ring. With symptomatic Schatzki ring had the evidence of significant gastroesophageal reflux either on endoscopy or ambulatory 24-h esophageal ph monitoring. Pathophysiology: The pathogenesis of Schatzki rings is not clear, and at least 4 hypotheses have been proposed. These hypotheses may not be mutually exclusive. Proposed hypotheses are as follows: 1. The ring is a pleat of redundant mucosa that forms when the esophagus shortens transiently or permanently for unknown reasons. 2 The ring is congenital in origin. 3.The ring is actually a short peptic stricture occurring as a consequence of gastroesophageal reflux disease. 4.The ring is a consequence of pill-induced esophagitis.

Video Endoscopic Sequence 3 of 3.

Lower Esophageal (Schatzki) Ring.

 With symptomatic Schatzki ring had the evidence of
 significant gastroesophageal reflux either on endoscopy
 or ambulatory 24-h esophageal ph monitoring. 
 Pathophysiology: The pathogenesis of Schatzki rings is not
 clear, and at least 4 hypotheses have been proposed.
 These hypotheses may not be mutually exclusive. Proposed
 hypotheses are as follows: 1. The ring is a pleat of
 redundant mucosa that forms when the esophagus shortens
 transiently or permanently for unknown reasons.
 2 The ring is congenital in origin.
 3.The ring is actually a short peptic stricture occurring as a
 consequence of gastroesophageal reflux disease.
 4.The ring is a consequence of pill-induced esophagitis.

                                          
                                         Medline.   

Lower Esophageal (Schatzki) Ring with esophageal varices and reflux esophagitis. A 59 year-old male with esophageal reflux disease presenting with episodes of cough and chest pain. 14 years ago, underwent a splecnectomy.

Video Endoscopic Sequence 1 of 2.

 Lower Esophageal (Schatzki) Ring with esophageal
 varices and reflux esophagitis.

 A 59 year-old male with esophageal reflux disease
 presenting with episodes of cough and chest pain.
 14 years ago, underwent a splecnectomy.
The image and the video display a retroflexed maneuver the Schatzki ring is appreciated with some varices. The image and the video display a retroflexed maneuver the Schatzki ring is appreciated with some varices. An endoscopist must be sure to diagnose a hiatal hernia in the absence of vomiting and coughs, because it may give a false positive diagnosis of hiatal hernia.

Video Endoscopic Sequence 2 of 2.

 The image and the video display a retroflexed maneuver
 the Schatzki ring is appreciated with some varices.

 An endoscopist must be sure to diagnose a hiatal hernia in
 the absence of vomiting and coughs, because it may give a
 false positive diagnosis of hiatal hernia.