Riverside Community/UC Riverside Riverside, California
Award: Presidential Poster Award
Mahesh Botejue, MD1, Dariush Shahsavari, MD2, Ron Schey, MD3, Zubair Malik, MD2, Henry P. Parkman, MD, FACG4; 1Riverside Community/UC Riverside, Riverside, CA; 2Temple University School of Medicine, Philadelphia, PA; 3University of Florida College of Medicine, Jacksonville, FL; 4Temple University, Philadelphia, PA
Introduction: Hiatal hernia (HH) is a relatively common disorder associated with GERD. HH can be diagnosed with radiology, endoscopy, surgically, as well as on esophageal manometry. Straight leg raising (SLR), which increases intraabdominal pressure, during high-resolution esophageal manometry (HREM) has the potential to be a useful adjunct in the detection of HH.
Aim: To determine the usefulness of performing SLR during (HREM). Specifically, to determine the prevalence of positive SLR for HH, the relationship between SLR and esophageal manometry findings, as well as the demographic and medical factors associated Methods: 436 patients undergoing HREM were given a modified Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and an additional 29-item questionnaire regarding the presence of HH and additional questions on symptoms and risk factors. Patients were stratified based on presence or absence of HH as detected by HREM, as well as by the presence or absence of positive SLR. Results: Of 436 patients (64.8% females, mean age 54.2±16.1 years, BMI 28.8±7.9 kg/m2), 216 (49.5%) had HH on baseline HREM. Patients with HH on baseline manometry were older, with higher BMI, lower LES pressure, and more significant heartburn (See Table 1). Of patients with HH on baseline HREM, 154 (71.3%) had positive SLR for HH. Twenty-four (10.9%) patients with negative HH on baseline HREM had positive SLR. Positive SLR for HH was associated with lower LES pressure. (See Table 2). Discussion: SLR helps in the detection of HH, bringing out a hiatal hernia in 11% of patients without one on baseline esophageal manometry. This study indicates that SLR may be a useful maneuver in the detection of HH in patients undergoing HREM.
Disclosures: Mahesh Botejue indicated no relevant financial relationships. Dariush Shahsavari indicated no relevant financial relationships. Ron Schey indicated no relevant financial relationships. Zubair Malik indicated no relevant financial relationships. Henry Parkman indicated no relevant financial relationships.