Q40.1: Congenital hiatus hernia

The diaphragm separates the chest cavity from the abdominal cavity. Above the diaphragm are the lungs and the heart. Beneath the diaphragm are the stomach, liver and spleen. In the diaphragm there are some openings which the large blood vessels and the esophagus run through.

The opening in the diaphragm is usually so narrow that only the esophagus fits through it. With a congenital hiatus hernia, the opening for the esophagus is widened due to a defect. A defect can occur if tissue is disturbed while it is developing in the womb. Due to the defect, your stomach is located partly or wholly above your diaphragm.

A hiatus hernia can cause various problems. For example, you may experience heartburn. Heartburn occurs if gastric acid from the stomach gets into the esophagus. Heartburn produces a burning, unpleasant sensation in the chest cavity. However, some hiatus hernias do not cause any discomfort.

The symptoms also depend on how much of the stomach is located above the diaphragm. If a large portion of the stomach is located in the chest cavity, there may be problems with breathing and the blood circulation. This is due to the fact that the lungs and heart have less space, so they cannot work properly.

The symptoms also depend on whether the stomach is being pinched in the diaphragm opening.