Table I.

Current diagnostic methods for hiatal hernia.

Diagnostic technique	Evaluation	Warnings
Barium swallow X-ray [1,3,5,6,13,14,16,17]	size, location of hernia, motility dysfunction, stenosis, stricture related to GERD, short esophagus diagnosis	contraindicated in pregnancy, barium or iodine hypersensitivity, exposure to radiation
Endoscopy [1,3,5,6,13,14,16,17]	analysis of esophageal mucosa, erosive esophagitis, Barrett’s esophagus, malignancy, Cameron’s ulcers, swallowing difficulty	air insufflation of the stomach may exaggerate hernia size, difficulty to assess massive hernias accurately
Manometry [1,3,5,6,13,14,16,17]	integrity of esophageal peristaltis, motility disorders, achalasia	difficulty in placing manometry catheter
pH testing [1,5,13,16,17]	quantitative analysis of reflux episodes
CT [3,13,16,17]	gastric volvulus, perforation, pneumoperitoneum, pneumomediastinum	unable to exactly define the configuration of the hernia, exposure to radiation