Hiatal hernia: Meaning in a Radiology Report

Hiatal hernia

Also written as: hiatus hernia, sliding hiatal hernia, paraesophageal hernia

A hiatal hernia means part of the stomach has pushed up through the opening in the diaphragm into the chest. Small ones are very common.

Seen on: CT, X-ray

How it reads in a report

Small sliding hiatal hernia; the remainder of the upper abdomen is unremarkable.

What it means

The diaphragm is the dome-shaped muscle between the chest and the belly. The food pipe (esophagus) passes through a gap in it, called the hiatus, to reach the stomach. In a hiatal hernia, the top of the stomach pushes up through this gap. In the common sliding type, the place where the food pipe meets the stomach moves up. In the rarer paraesophageal type, part of the stomach rolls up beside the food pipe.

When it matters

Small sliding hiatal hernias are very common, especially with age and extra weight, and often cause no symptoms. They can go along with heartburn and acid reflux. Large hernias and the paraesophageal type are watched more closely, because in rare cases the stomach can twist or get trapped. If you have symptoms, your doctor may suggest a camera test of the stomach (endoscopy) or a visit to a surgeon.

Questions to ask your doctor

Is it a small sliding hernia, or the paraesophageal type?
Could it be causing my heartburn, reflux or chest discomfort?
Does it need any treatment or follow-up if I have no symptoms?

General information, not medical advice. What a finding means for you depends on your symptoms, your history and the images themselves, so talk your results through with a doctor.