| Hiatal hernias: a review of the pathophysiologic theories and implication for research. | |
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MedLine Citation:
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PMID: 21528392 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The pathophysiology of hiatal hernias is incompletely understood. This study systematically reviewed the literature of hiatal hernias to provide an evidence-based explanation of the pathogenetic theories and to identify any risk factors at the molecular and cellular levels. METHODS: A systematic search of the Medline and Pubmed databases on the pathophysiology of hiatal hernias was performed to identify English-language citations from the database inception to December 2010. RESULTS: Although few studies have examined the relationship of molecular and cellular changes of the diaphragm to the pathogenesis of hiatal hernias, there appear to be three dominant pathogenic theories: (1) increased intraabdominal pressure forces the gastroesophageal junction (GEJ) into the thorax; (2) esophageal shortening due to fibrosis or excessive vagal nerve stimulation displaces the GEJ into the thorax; and (3) GEJ migrates into the chest secondary to a widening of the diaphragmatic hiatus in response to congenital or acquired molecular and cellular changes, such as the abnormalities of collagen type 3 alpha 1. CONCLUSIONS: The pathogenesis of hiatal hernias at the molecular and cellular levels is poorly described. To date, no single theory has proved to be the definitive explanation for hiatal hernia formation, and its pathogenesis appears to be multifactorial. |
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Authors:
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C Weber; C S Davis; V Shankaran; P M Fisichella |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-29 |
Journal Detail:
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Title: Surgical endoscopy Volume: - ISSN: 1432-2218 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8806653 Medline TA: Surg Endosc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Surgery, Loyola University Medical Center, Stritch School of Medicine, 2160 South First Avenue, Room 3226, Maywood, IL, 60153, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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