Abstract
The purpose — to show the possibilities of the classical X-ray research method for the diagnosis of hernias of the diaphragm esophageal opening. Material and methods. A classical X-ray examination of 138 patients with hiatal hernia was performed. Initially, a study of the chest organs and posterior mediastinum was carried out. A contrast study of the esophagus and stomach with a barium suspension was carried out in a horizontal position of the patient on the back and on the stomach, as well as vertically. Results. Mostly axial hiatal hernias were diagnosed — in 134 patients (97.1%), including 42 (31.3%) with esophageal shortening due to scarring and 92 (68.6%) sliding hernias; signs of intussusception were revealed in 2 cases. In one patient, along with the esophageal shortening, 2 «niches» were identified due to ulceration, which were confirmed by endoscopy. Paraesophageal hernias were found in 4 cases (2.9%), in all four cases the hernias were fixed; in one case, a total hernia with a volvulus of the stomach was diagnosed. In case of 23 (17.1%) patientsaxial hiatal hernias were combined with esophageal or gastric cancer. X-ray findings were confirmed by upper GI endoscopy. Conclusion. The up-to-date, correctly performed X-ray examination made it possible not only to reveal a hiatal hernia, but also to determine its type, to study the function of the esophageal-gastric junction and the presence of complications.
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