Assessment of hiatus defect size in hiatal hernia patients using computed tomography

Objectives: The aim of this study is to investigate the hiatus defect diameter by measuring on multi-detector computed tomography images in hiatal hernia patients. Methods: The multi-detector computed tomography images of 50 patients and 50 individuals in control group included in this study were investigated. The hiatus surface area (cm²), hiatus antero-posterior and transverse diameters (cm), and the thickness of both diaphragmatic crura (mm) were measured by reformatting contrast-enhanced thoraco-abdomino-pelvic computed tomography images using the region of interest method. Results: In this study, a significant difference was obtained among groups according to hiatus surface area, hiatus antero-posterior, and transverse diameter measurements, and both left and right diaphragmatic crural thickness measurements (P<0.001). In the patient group, the cut-off values were determined by using ROC analysis, and the values above these cut-off values enabled a hernia diagnosis with high sensitivity and specificity. Conclusions: Measuring the hiatus surface area on multi-detector computed tomography images could serve as a supplementary criterion for diagnosing of hiatal hernia.