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Why BARIUM SWALLOW failed to identify PARAESOPHAGEAL HERNIA?

Resolved Question:

Hello,

I am now confused..
1st endoscopy showed 2 cm hiatal hernia - doc said not a concern, also pathology came back as eosinophilia ( only did lower stomach sampling). Doctor kept trying different ppi's that did not work

I decided to get another opinion from Mayo Clinic specialist. A second endoscopy was done within 6 weeks. it showed a large para esophageal hernia and no eosinophilia issues ( only in stomach). T

Then had a manometry test who he'd concluded absence of peristalsis in lower esophagus. mayo specialist scheduled appt with surgeon.

This morning had barium swallow. That doctor said he did not see the para esophageal hernia.

Now, I am waiting for my next appt with Gatrologist to discuss all tests and then the following day meeting with surgeon.


But, I am now very confused as to why the endoscopy showed the para esophageal hernia and the barium swallow did not.. Which one is more reliable? Can this be something else?

Thank you.

Wendy


Category: Gastroenterologist, Surgical

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Category: Gastroenterologist, Surgical
Dr. Lokesh HM is online now

Expert:  Dr. Lokesh HM replied 4 Days.

Hello Wendy,
Thank you for your query at DoctorSpring.com
I understand your concern.
Both Endoscopy and barrium studies are accurate in detecting paraesophageal hernia if properly done.

Might be while doing barrium study specific maneuver might not have been done to delineate the hernia.Also in endoscopy personal variations will be there.

Other possibility would be Achalasia cardia with diverticulum (by considering your monometry and other investigation reports)

Please provide your symptoms and the report of your barrium study finding.
Regards
Dr. Lokesh


Dr. Lokesh HM
Category: Gastroenterologist, Surgical
Experience: 
Fellowship: Minimal Access Surgery (FMAS)
Fellowship: Pancreato-Biliary surgery (FPBS), SGPGI Lucknow, 2012
Senior Residency: MCh, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI) Lucknow, 2011
Junior Residency: MS, PGIMER, Chandigarh, 2008
Medical School: MBBS, MS from Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, 2007
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