Hiatus Hernia in Nigerians – An Endoscopic Study

Abstract

Hiatus hernia is considered to be rare in Nigerians. Older radiological studies utilizing barium suggest 0.39% prevalence. More recent retrospective endoscopic studies in Nigeria suggest that the prevalence ranges from 2% to 28% but it is unclear how the diagnosis was made. A prospective study examining consecutive videos of the retroflexed view of patients undergoing endoscopy was carried out to determine grades of gastroesophageal disruption. The fundal area was also examined for paraesophageal hernia. Of 193 patients who had endoscopy in the study period, after excluding repeat endoscopies and patients with proximal obstructing lesions, 151 had clear unobstructed retroflexed views. Grade IV gastro-esophageal junction disruption (hiatus hernia) was seen in 5 (3.3%) patients while 4 (2.6%) had grade III disruption. Twenty-five (16.6%) had grade II while 117(77.5%) of the patients had grade I (normal). None of the patients had paraesophageal hernia. Hiatus hernia and major gastro esophageal junction disruption are relatively rare in Nigerian patients who underwent endoscopy.