Gastroesophageal Reflux without Hiatus Hernia vs. Gastroesophageal Reflux with Hiatus Hernia

Gastroesophageal Reflux without Hiatus Hernia vs. Gastroesophageal Reflux with Hiatus Hernia

Left picture: Only an obtuse angle of His between esophagus and gastric fundus is depicted as indication of an acid reflux confirmed by pH-metry. Following an esophagoscopy a non-operative treatment of the reflux can be started as a tentative measure. Right picture: Here, as an indication of an acid reflux which was comfirmed by a pH-metry, a hiatus hernia with a permanent middle-sized epiphrenic gastric pouch is present. A fundoplication is indicated.

Two patients with chronic vomiting. Besides pH-metry, an upper gastrointestinal contrast study was performed due to the long duration of vomiting and due to hematin vomiting. Left picture: The depicted part of the esophagus and the stomach seems to be inconspicuous in the lateral view. Right picture: Here, a mushroom-like structure is demonstrated between the esophagus and the stomach which is filled completely with contrast except for some air.