Aliotta A, Rapaccini G L, Pompili M, Grattagliano A, Cedrone A, Trombino C, De Luca F, De Vitis I
Istituto de Clinica Medica, Università Cattolica del Sacro Cuore, Rome, Italy.
J Ultrasound Med. 1995 Jun;14(6):457-61. doi: 10.7863/jum.1995.14.6.457.
This study was conducted to identify the sonographic findings that might be used to diagnose sliding gastric hiatal hernia. We first performed a retrospective evaluation of 12 patients known to have sliding hiatal hernia and 18 normal controls. In the controls the esophagogastric junction could be visualized clearly in all cases and the alimentary tract section at the diaphragmatic hiatus ranged from 7.1 to 10.0 mm. The esophagogastric junction was not visualized in any of the hernia patients, whose alimentary tract diameters ranged from 16.0 to 21.0 mm. These two markers (nonvisualization of the junction and diameter greater than 16 mm) were then evaluated for their ability to predict the occurrence of sliding hiatus hernia in a prospective study of 38 patients subsequently diagnosed by means of barium contrast examinations and endoscopy. In this group, each sign had a positive predictive value of 100%. The negative predictive value of the alimentary tract diameter was 90%; that of nonvisualization of the esophagogastric junction was 94.7%. Inclusion of ultrasonography in the initial work-up of patients with symptoms of gastroesophageal reflux may reduce the need for more invasive diagnostic procedures.
本研究旨在确定可用于诊断滑动性食管裂孔疝的超声检查结果。我们首先对12例已知患有滑动性食管裂孔疝的患者和18例正常对照者进行了回顾性评估。在对照组中，所有病例的食管胃交界均可清晰显示，膈裂孔处的消化道段长度为7.1至10.0毫米。在任何一例疝患者中均未显示食管胃交界，其消化道直径为16.0至21.0毫米。然后，在一项对随后通过钡剂造影检查和内镜检查确诊的38例患者的前瞻性研究中，评估了这两个指标（交界未显示和直径大于16毫米）预测滑动性食管裂孔疝发生的能力。在该组中，每个体征的阳性预测值均为100%。消化道直径的阴性预测值为90%；食管胃交界未显示的阴性预测值为94.7%。在对有胃食管反流症状的患者进行初步检查时采用超声检查，可能会减少对侵入性更强的诊断程序的需求。
