Accuracy of Ultrasonography in the Diagnosis of Sliding Hiatal Hernias

Rationale and Objectives: Diagnostic measures that can be used for sliding hiatal hernia are barium swallow radiography, endoscopy, manometry, and computed tomography. The aim of this study was to evaluate the diagnostic accuracy of transabdominal ultrasonography for sliding hiatal hernias. Materials and Methods: This retrospective study was performed in the radiology department of a tertiary care center between May 2011 and May 2012. Twenty-one patients (10 females, 11 males) with sliding hiatal hernias and 41 controls (37 females, 4 males) were enrolled in this study. Esophageal hiatal diameters measured by ultrasonography and computerized tomography were compared. Correlation was tested via Pearson correlation analysis. Results: The average age of patients and controls were 58.6 and 40.1, respectively. There was a statistically significant-difference between esophageal hiatal diameters measured via ultrasonography in patients (31.7 mm) and controls (11.6 mm) (P < .001). Similarly, esophageal hiatal diameters measured via computed tomography in patients (31.4 mm) was statistically significantly higher than controls (11.5 mm) (P < .001). The average body mass index of patients (28.3) was higher than that of control group (P = .015). Ultrasonographic measurements were correlated well with tomographic results (P = .000, r = 0.995). Conclusion: Ultrasonography seems to be a valuable, safe, and practical alternative that avoids the side effects of contrast agents in the diagnosis of sliding hiatal hernias. Overall, we suggest that inclusion of ultrasound in the initial diagnostic steps for patients with sliding hiatal hernias may reduce the requirement for more expensive procedures.