9 - The Association of Hiatal Hernias and Age: A Cadaveric Study

Poster Board Number: 9
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : Purpose: A hiatal hernia is a protrusion of part of the stomach into the esophagus or diaphragm. These patients can present as symptomatic or asymptomatic. Common symptoms include gastroesophageal reflux, chest pain, nausea, and dyspepsia, among others. It has been hypothesized that as age progresses, the diaphragm becomes weak allowing a hernia to form. Current literature approximates that 50-60% of individuals over the age of 50 have a hiatal hernia (Smith et al. 2022). If left untreated, gastric reflux may form a precancerous lesion, Barrett’s esophagus, which could transform into esophageal adenocarcinoma. The goal of this study is to evaluate the relationship between age and the prevalence of hiatal hernias in cadavers.

Methods: The thorax and abdomen of 30 formalin-embalmed cadavers were opened to reveal the diaphragm and esophagus. The stomach, diaphragm, and esophagus were examined to evaluate for the presence of the two different types of hiatal hernias, sliding and paraesophageal. Photographs were taken of this area as well as measurements to assess the degree of herniation, if any, present in the donors. Pearson correlation was utilized in the analyses of the data.

Results: The type of hernia and the extent of herniation were compared to see what relationship exists between age and hiatal hernias. We also examined each type of hernia individually to see if there were statistical relationships with other known demographic information about the donor.

Conclusion: When evaluating older patients with vague symptoms such as gastroesophageal reflux, chest pain, nausea, and dyspepsia, a hiatal hernia should be high on the differential diagnosis list for the medical clinician. This can be used as a means of prevention for Barrett’s, which could lead to esophageal cancer. With the advancement of age, the body changes, such as the weakening of muscles including the diaphragm. The weakening of the diaphragm allows the esophagus and stomach to move, creating a hiatal hernia. This herniation can lead to more issues than just gastrointestinal issues. Medical clinicians should be mindful of this when treating older patients.

Significance/Implication: Since it is known that Barrett’s esophagus can lead to cancer, understanding how this may occur relative to hiatal hernias and age is important. By adding a potential hernia to a differential diagnosis, clinicians can assist in reducing the chance of this cancer in their patients and lead to the reduction of this preventable cancer within the population as a whole.