Gastroenterology · UKMLA & AKT
Hiatus hernia
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise hiatus hernia — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Heartburn - burning retrosternal discomfort, worse after meals, lying flat, or bending forward
- Regurgitation - effortless return of acid/food, worse at night; risk of aspiration and chronic cough
- Dysphagia - suggests oesophagitis, stricture, or mechanical compression from large rolling hernia
- Iron deficiency anaemia - Cameron lesions (linear erosions at diaphragmatic hiatus in large hernias)
Rolling hernia acute emergency: severe chest pain + retching without vomiting + inability to pass NG tube = Borchardt's triad of gastric volvulus. Do not be falsely reassured by absence of GORD symptoms.
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