Endoscopic, radiologic and manometric correlation in small sliding hiatal hernia.

Of the three methods employed, endoscopy seems to be the most accurate since it permits identification of both anatomical structures and serves as a basis for interpretation of radiology and manometry. Cardial incisura was the easiest and most constantly identifiable structure by the three methods. It must be considered as the union between esophagus and stomach. In small sliding hiatal hernia, the cardial incisura remains below the diaphragm and the gastric mucosa slides up into the chest, resulting in a partial prolapse (hiatal hernia of sliding mucosa). This concept would clarify the difference in interpretation of the most commonly used procedures in diagnosis of sliding hiatal hernia.