We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Esophageal Hiatal Hernia and Gastric Acid Secretion

Arch Surg. 1964;88(2):255-259. doi:10.1001/archsurg.1964.01310200093020.
Text Size: A A A
Published online


Experience with the transthoracic approach to the repair of sliding esophageal hiatal hernia has demonstrated that adequate anatomic repair is not consistently followed by amelioration of symptoms. Further studies of several of these unsuccessfully treated patients have revealed the hitherto undetected presence of high levels of gastric acid secretion not infrequently accompanied by duodenal ulcer. Analysis of large groups of patients with duodenal ulcer and with esophageal hiatal hernia has emphasized the striking similarity of symptoms presented by both groups of patients: retrosternal and subxiphoid pain and burning, regurgitation, pyrosis, flatulence, vomiting, and bleeding. This clinical evaluation pointed to a common pathophysiologic mechanism for the production of symptoms, and the studies herein reported were undertaken to evaluate the nature of the mechanism.

It is well known that the presence of a sliding esophageal hernia is not necessarily associated with symptoms. The question may validly be proposed: is the dislocation of


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.