Aims and objectives
Although a barium-contrast radiography originally constituted the first development in diagnosing hiatal hernia (HH) and gastroesophageal reflux,
nowadays conventional radiology is no more an accurate investigation for their assessment.
we noticed a tendency to a negative contribution to the management of these conditions.
we observed in clinical practice a worrisome rate of HH reported as incidental extra-colonic finding during CT with water enema (CT-WE) and CT...
Methods and materials
Inclusion of patients This was a retrospective study,
approved by our institutional review board.
The primary study groups were derived from 400 consecutive patients,
200 undergoing CT-WE and 200 undergoing CTC at our unit of radiology starting from January 1,
The mean age of the CT-WE cohort (118 women,
82 men) was 66.5 ± 14.2 (SD) years,
while the mean age of the CTC group (127 women,
73 men) was 65.7 ± 12.4 (SD) years.
Among the patients with a HH at CT-WE and CTC,
PACS record review...
No statistical significant differences were found among the groups enrolled in terms of demographic and epidemiological characteristics ( Table 1 ). A sliding hiatal hernia was present in 51% (102/200) of the patients belonging to the CT-WE cohort and in 48.5% (97/200) of the patients in the CTC group.
In CT-WE patients,
hernia size was reported as small in 82.4% (84/102) of patients,
moderate in 12.7% (13/102),
and large in 4.9% (5/102).
In CTC patients,
hernia size was categorized as small...
The main source of inspiration for this work was the study by Pickhardt et al.
 affirming that small transient sliding hiatal hernias are commonly induced by colonic distention at CTC and should not be reported: their results pushed us to verify if such circumstance was relevant for CT-WE as well,
in order to start correcting a trend of over-reporting and the resulting inappropriate management of these patients. The evaluation of complex and panoramic exams such as abdominal CT with water...
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et al (2010) Characteristics of reflux episodes and symptom association in patients with erosive...