Gastroenterology · UKMLA & AKT
Hiatus hernia
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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