Department of Gastroenterology, Korea University Guro Hospital, Seoul, Korea.
J Neurogastroenterol Motil. 2010 Jan;16(1):35-9. doi: 10.5056/jnm.2010.16.1.35. Epub 2010 Jan 31.
Hiatal hernia (HH) is a well-known contributory factor of gastroesophageal reflux disease (GERD). However, studies on the clinical significance of simple small HH are lacking. We conducted a study to clarify the clinical significance of short segment HH (SSHH) in relation to GERD.
4,592 consecutive cases (male/female: 2,076/2,516, median age: 49 years) examined with diagnostic esophagogastroduodenoscopy for the first time were enrolled. During the insertion of endoscope, presence of HH was determined and the length was measured, if present. The relationships between gender, age, presence of erosive esophagitis, and columnar-lined esophagus (CLE) and the lengths of HH were analyzed.
Among 4,592 cases, HH was present in 428 cases (9.3%); SSHH was found in 255 cases (5.6%) and long segment HH (LSHH) in 173 cases (3.8%). HH was more frequent among males and patients with LSHH tended to be older. Erosive esophagitis was observed in 4.8%, 22.0%, and 37.0% of no HH, SSHH, and LSHH group, respectively (p <0.05). CLE was observed in 14.4%, 36.5%, and 24.3% of no HH, SSHH, and LSHH group, respectively (p <0.05).
SSHH is not a clinically silent and "innocent entity," but rather a condition with a significant pathologic significance similar to LSHH in regard to GERD.
食管裂孔疝（HH）是胃食管反流病（GERD）的一个众所周知的致病因素。然而，关于单纯小 HH 的临床意义的研究尚缺乏。我们进行了一项研究，旨在阐明短节段 HH（SSHH）与 GERD 的临床意义。
共纳入 4592 例首次接受诊断性食管胃十二指肠镜检查的连续病例（男/女：2076/2516，中位年龄：49 岁）。在内镜插入过程中，如果存在 HH，则确定其存在并测量其长度。分析 HH 的存在与性别、年龄、有无糜烂性食管炎和柱状上皮化生（CLE）的关系以及 HH 的长度。
在 4592 例病例中，428 例（9.3%）存在 HH；255 例（5.6%）为 SSHH，173 例（3.8%）为 LSHH。HH 在男性中更为常见，而 LSHH 患者年龄较大。无 HH、SSHH 和 LSHH 组中分别有 4.8%、22.0%和 37.0%的患者存在糜烂性食管炎（p<0.05）。无 HH、SSHH 和 LSHH 组中分别有 14.4%、36.5%和 24.3%的患者存在 CLE（p<0.05）。
SSHH 不是一种临床无症状和“无害实体”，而是一种与 LSHH 相似的具有显著病理意义的疾病，与 GERD 有关。
