Surgical or conservative treatment in hiatal hernias in children: a new decisive parameter.

The authors have investigated the role of gastric acidity in the evaluation of cardiohiatal anomalies. Results are given of maximal gastric acid (MAO) investigations made in 155 children. Children in whom postural therapy failed and those with an ulcerlike syndrome have much higher MAO values than does the group who responded well to postural therapy and to a control group. Hyperacidity indicates a high probability of a poor response to postural therapy. Therefore measurement of gastric acidity is advisable in all patients with hiatus hernia, and early surgical therapy should be recommended in those with hyperacidity.