ABSTRACT
Objective To discuss the clinical values of two-dimensional and three-dimensional diagnoses of nontraumatic esophageal hiatal hernia (HH) in middle-aged and elderly people. Methods Thirty-two cases underwent two-dimensional and three-dimensional ultrasonic examination with fasting and water iflling methods in half-sitting, standing, supine and supine right anterior oblique positions. The ifndings were compared with X-ray barium meal examination, endoscopy and operation. Results There were 27 cases sliding HH, 3 cases paraesophageal HH and 2 cases short HH. Traditional two-dimensional manifestations were as follows:widening of hiatal diaphragmatic muscles (1.6±0.4 cm) and echoes of gastric mucosa in superior hernial sac and inside hernial sac. Real-time three-dimensional surface image formations were as follows: along the long axis of diaphragmatic hiatus, superior phrenic sac was showed as mushroom-shaped or pond-shaped and the neck of hernial sac was showed as irregular tunnel-shaped or ditch-shaped;looking upward from the fundus of stomach, superior phrenic hiatus was showed as caved-shaped or louver-shaped;looking downward from mediastinal surface of lung, uperior phrenic hiatus was showed as piercer-shaped. Conclusions Two-dimensional abdominal ultrasound can diagnose nontraumatic HH in middle-aged and elderly people conveniently and accurately. Real-time three-dimensional abdominal ultrasound can display the range, size, and shape clearly. Compared with the former, the latter can provide more information for diagnosis and help ultrsound doctors and clinical doctors to understand and master the anatomical and morphopathological features of this disease.