{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T05:06:06Z","timestamp":1740632766729,"version":"3.38.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Traditional investigations of esophageal hiatal assessment for reflux disease and hiatal hernia (HH), such as endoscopy and barium swallow are subjective. High resolution manometry (HRM) limits hiatal hernia assessment to vertical length. We report a novel use of 3D volumetric Computed Tomography with effervescent oral contrast (Fizz-CT) as a means of preoperative HH diagnosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A pilot series of 12 consecutive patients who underwent preoperative Fizz-CT assessment, as well as a combination of traditional investigations for HH (five primary, seven revisional HH).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The median age was 70years (IQR 57.5-76.8years) and median BMI 28.62\u00a0kg\/m<jats:sup>2<\/jats:sup> (IQR 24.9\u201334.1\u00a0kg\/m<jats:sup>2<\/jats:sup>). Seven patients (58%) had a recurrent HH and five patients (42%) had a primary hiatus hernia. Fizz-CT was able to diagnose the HH in all cases. The median oesophageal hiatal surface area (HSA) was 9.46cm<jats:sup>2<\/jats:sup> (IQR 4.66-13.79cm<jats:sup>2<\/jats:sup>). The median HH sac volume was 36.3cm<jats:sup>3<\/jats:sup> (IQR 26.0-80.3cm<jats:sup>3<\/jats:sup>). All patients had a least one other investigation that has been traditionally used to diagnose HH. Seven of the 12 patients subsequently underwent laparoscopic HH repair surgery with intraoperative findings further confirming the radiological diagnosis of hiatus hernia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Fizz-CT imaging is a novel and accurate means of objective esophageal hiatal assessment in both primary and revisional HH patients. Vertical and radial measures of hiatal defects as well as hernia volumetry can be obtained. In post-surgical patients the relationship between the esophago-gastric junction and an infra- or supra-diaphragmatic fundoplication can also be assessed.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00423-025-03647-2","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T04:55:32Z","timestamp":1740545732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fizz-computed tomography as a novel modality of objective esophageal hiatal assessment"],"prefix":"10.1007","volume":"410","author":[{"given":"Daniel Leonard","family":"Chan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace Huan","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Chug","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie","family":"Hennessy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Iliopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Leonard","family":"Talbot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"issue":"4","key":"3647_CR1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/S1052-5157(18)30334-9","volume":"6","author":"AP Weston","year":"1996","unstructured":"Weston AP (1996) Hiatal hernia with cameron ulcers and erosions. Gastrointest Endosc Clin N Am 6(4):671\u2013679","journal-title":"Gastrointest Endosc Clin N Am"},{"issue":"4","key":"3647_CR2","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1080\/17474124.2018.1441711","volume":"12","author":"HX Yu","year":"2018","unstructured":"Yu HX, Han CS, Xue JR, Han ZF, Xin H (2018) Esophageal hiatal hernia: risk, diagnosis and management. Expert Rev Gastroenterol Hepatol 12(4):319\u2013329","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"4","key":"3647_CR3","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s00276-011-0904-9","volume":"34","author":"C Dean","year":"2012","unstructured":"Dean C, Etienne D, Carpentier B, Gielecki J, Tubbs RS, Loukas M (2012) Hiatal hernias. Surg Radiol Anat 34(4):291\u2013299","journal-title":"Surg Radiol Anat"},{"issue":"6","key":"3647_CR4","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1002\/jgh3.12388","volume":"4","author":"DL Chan","year":"2020","unstructured":"Chan DL, Wong SK, Lok HT, Iliopoulos J, Talbot ML, Hennessy A et al (2020) Accuracy of hiatal hernia diagnosis in bariatric patients: preoperative endoscopy versus intraoperative reference. JGH Open 4(6):1074\u20131078","journal-title":"JGH Open"},{"issue":"10","key":"3647_CR5","doi-asserted-by":"publisher","first-page":"e14605","DOI":"10.1111\/nmo.14605","volume":"35","author":"S Sanagapalli","year":"2023","unstructured":"Sanagapalli S, Plumb A, Lord RV, Sweis R (2023) How to effectively use and interpret the barium swallow: current role in esophageal dysphagia. Neurogastroenterol Motil 35(10):e14605","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"3647_CR6","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/jgh.14758","volume":"35","author":"L Li","year":"2020","unstructured":"Li L, Gao H, Zhang C, Tu J, Geng X, Wang J et al (2020) Diagnostic value of X-ray, endoscopy, and high-resolution manometry for hiatal hernia: a systematic review and meta-analysis. J Gastroenterol Hepatol 35(1):13\u201318","journal-title":"J Gastroenterol Hepatol"},{"issue":"2","key":"3647_CR7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1111\/nmo.12494","volume":"27","author":"A Patel","year":"2015","unstructured":"Patel A, Ding A, Mirza F, Gyawali CP (2015) Optimizing the high-resolution manometry (HRM) study protocol. Neurogastroenterol Motil 27(2):300\u2013304","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"3647_CR8","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/0149-936X(81)90051-5","volume":"5","author":"MM Lindell Jr","year":"1981","unstructured":"Lindell MM Jr., Bernardino ME (1981) Diagnosis of hiatus hernia by computed tomography. J Comput Tomogr 5(1):16\u201319","journal-title":"J Comput Tomogr"},{"issue":"4","key":"3647_CR9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/BF01889220","volume":"14","author":"W Vas","year":"1989","unstructured":"Vas W, Malpani AR, Singer J, Sundaram M, Chenoweth J (1989) Computed tomographic evaluation of paraesophageal hernia. Gastrointest Radiol 14(4):291\u2013294","journal-title":"Gastrointest Radiol"},{"issue":"9","key":"3647_CR10","doi-asserted-by":"publisher","first-page":"2656","DOI":"10.1007\/s00261-019-02279-7","volume":"45","author":"AS Moten","year":"2020","unstructured":"Moten AS, Ouyang W, Hava S, Zhao H, Caroline D, Abbas A et al (2020) In vivo measurement of esophageal hiatus surface area using MDCT: description of the methodology and clinical validation. Abdom Radiol (NY) 45(9):2656\u20132662","journal-title":"Abdom Radiol (NY)"},{"issue":"6","key":"3647_CR11","doi-asserted-by":"publisher","first-page":"2465","DOI":"10.1007\/s00464-015-4499-9","volume":"30","author":"W Ouyang","year":"2016","unstructured":"Ouyang W, Dass C, Zhao H, Kim C, Criner G (2016) Multiplanar MDCT measurement of esophageal hiatus surface area: association with hiatal hernia and GERD. Surg Endosc 30(6):2465\u20132472","journal-title":"Surg Endosc"},{"key":"3647_CR12","first-page":"100085","volume":"9","author":"DL Chan","year":"2023","unstructured":"Chan DL, Huang BW, Yip J, Chug M, Iliopoulos J, Hennessy A et al (2023) CT oesophageal hiatal surface area measurements: an objective and sensitive means of hiatal hernia detection. Surg Open Dig Adv 9:100085","journal-title":"Surg Open Dig Adv"},{"issue":"3","key":"3647_CR13","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1007\/s11695-021-05850-8","volume":"32","author":"SA Ayuso","year":"2022","unstructured":"Ayuso SA, Robinson JN, Okorji LM, Thompson KJ, McKillop IH, Kuwada TS et al (2022) Why size matters: an evaluation of gastric pouch size in Roux-en-Y gastric bypass using CT Volumetric Analysis and its effect on marginal Ulceration. Obes Surg 32(3):587\u2013592","journal-title":"Obes Surg"},{"issue":"8","key":"3647_CR14","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.1007\/s11695-022-06110-z","volume":"32","author":"W Catchlove","year":"2022","unstructured":"Catchlove W, Liao S, Lim G, Brown W, Burton P (2022) Mechanism of staple line Leak after Sleeve Gastrectomy via Isobaric Pressurisation Concentrating Stress Forces at the proximal staple line. Obes Surg 32(8):2525\u20132536","journal-title":"Obes Surg"},{"issue":"1","key":"3647_CR15","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1177\/155335060601300108","volume":"13","author":"SM Kavic","year":"2006","unstructured":"Kavic SM, Segan RD, George IM, Turner PL, Roth JS, Park A (2006) Classification of hiatal hernias using dynamic three-dimensional reconstruction. Surg Innov 13(1):49\u201352","journal-title":"Surg Innov"},{"issue":"20","key":"3647_CR16","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","volume":"310","author":"World Medical Association Declaration","year":"2013","unstructured":"World Medical Association Declaration (2013) Of Helsinki: ethical principles for medical research involving human subjects. JAMA 310(20):2191\u20132194","journal-title":"JAMA"},{"issue":"6","key":"3647_CR17","doi-asserted-by":"publisher","first-page":"e010973","DOI":"10.1136\/bmjopen-2015-010973","volume":"6","author":"SY Hu","year":"2016","unstructured":"Hu SY, Hsieh MS, Lin MY, Hsu CY, Lin TC, How CK et al (2016) Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study. BMJ Open 6(6):e010973","journal-title":"BMJ Open"},{"issue":"12","key":"3647_CR18","doi-asserted-by":"publisher","first-page":"1902","DOI":"10.1016\/j.soard.2020.07.024","volume":"16","author":"MA Arnoldner","year":"2020","unstructured":"Arnoldner MA, Felsenreich DM, Langer FB, Weber M, Mang T, Kulinna-Cosentini C et al (2020) Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a migration crisis? Surg Obes Relat Dis 16(12):1902\u20131908","journal-title":"Surg Obes Relat Dis"},{"issue":"2","key":"3647_CR19","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.ejrad.2014.11.008","volume":"84","author":"KI Ringe","year":"2015","unstructured":"Ringe KI, Meyer S, Ringe BP, Winkler M, Wacker F, Raatschen HJ (2015) Value of oral effervescent powder administration for multidetector CT evaluation of esophageal cancer. Eur J Radiol 84(2):215\u2013220","journal-title":"Eur J Radiol"},{"issue":"22","key":"3647_CR20","doi-asserted-by":"publisher","first-page":"2078","DOI":"10.1001\/archinternmed.2009.427","volume":"169","author":"R Smith-Bindman","year":"2009","unstructured":"Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Gould R et al (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 169(22):2078\u20132086","journal-title":"Arch Intern Med"},{"issue":"2","key":"3647_CR21","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s00455-021-10291-7","volume":"37","author":"SV Tipnis","year":"2022","unstructured":"Tipnis SV, Huda W, Wilmskoetter J, Martin-Harris B, Bonilha HS (2022) Radiation effective doses to adults undergoing modified Barium Swallow studies. Dysphagia 37(2):399\u2013406","journal-title":"Dysphagia"},{"issue":"11","key":"3647_CR22","doi-asserted-by":"publisher","first-page":"2669","DOI":"10.1002\/wjs.12354","volume":"48","author":"J S\u00fcsstrunk","year":"2024","unstructured":"S\u00fcsstrunk J, Stimpfle D, Wilhelm A, Ghielmini EM, Potthast S, Zingg U (2024) Clinical and computed tomography outcomes after mesh-enforced hiatoplasty and anterior hemi-fundoplication in large hiatal hernia repair. World J Surg 48(11):2669\u20132677","journal-title":"World J Surg"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-025-03647-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-025-03647-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-025-03647-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T04:55:34Z","timestamp":1740545734000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-025-03647-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3647"],"URL":"https:\/\/doi.org\/10.1007\/s00423-025-03647-2","relation":{},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,26]]},"assertion":[{"value":"1 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The patients that are the subject of this case series have provided their informed consent for the use of their de-identified information for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"83"}}