Authors: C Weber C S Davis V Shankaran P M Fisichella
Publish Date: 2011/04/29
Volume: 25, Issue: 10, Pages: 3149-
Abstract
The pathophysiology of hiatal hernias is incompletely understood This study systematically reviewed the literature of hiatal hernias to provide an evidencebased explanation of the pathogenetic theories and to identify any risk factors at the molecular and cellular levelsAlthough 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
Keywords: