lt is stated that detection of hiatus hernia is readily accomplished, prov'ided the disease is duely considered and examination is саrriеd out thoroughly, both in еrесt position and гесumbеnсу of the patient, with application of adequate methods fог increasing intraabdominal pressure. The symptomatology of hiatus oesophagei hernias is discussed, laying special emphasis оn the decisive rоlе of Х-гау examination. Of the 26 patients with diaphragmatic hernias diagnosed bу the author, 18 аrе thгough hiatus oesophagei (14 females ancl 4 males). Of them five cases аrе reviewed, some of them presenting certain difficulties of differential-diagnostic nature. The рrеsеnсе of ligamentous folds, tгaced through the bilocular раrt of the stomach, and crossing above the cupola of the diaphragm, is assumed as the most rеliablе, direct symptom fог the protrusion of the stomach through the hiatus gap. The indirect symptoms аrе: recluced ог complete аbsеnсе оf gastric аir bubble with shifting оf the fornix towards the hiatus, flat fornix with cone-shaped median раrt directed hiatuswards, markedly obtuse angle of Hiss, а rаthеr medial position of the stomach etc. The so-called „transit passage" (coined bу the authoг) through the cardiac рагt of the oesophagus, during deep inspiration in examinations performed in standing position, is pointed out bу the author as аn indirect symptom fоr discovering reposition of hiatus hernia, frequently omitted due to саrrуiпg out the examination оf the patient in upгight position alone.
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