What is the Difference Between Diaphragmatic Hernia and Hiatal Hernia

Diaphragmatic hernia and hiatal hernia are two types of hernias. A hernia happens when an organ or tissue pushes through a weak spot in the surrounding muscle or tissue. Hernia can be dangerous. Both these types of hernias involve herniation through the diaphragm.

The key difference between diaphragmatic hernia and hiatal hernia is the specific location and structures involved. Diaphragmatic hernia occurs when an opening in the diaphragm allows organs from the abdomen, such as the stomach, intestines, spleen, liver, or kidney, to move up into the chest cavity, while hiatal hernia occurs when part of the stomach pushes up through an opening in the diaphragm into the chest cavity. 

CONTENTS

1. Overview and Key Difference
2. What is Diaphragmatic Hernia 
3. What is Hiatal Hernia
4. Similarities – Diaphragmatic Hernia and Hiatal Hernia
5. Diaphragmatic Hernia vs Hiatal Hernia in Tabular Form
6. Summary – Diaphragmatic Hernia vs Hiatal Hernia
7. FAQ – Diaphragmatic Hernia and Hiatal Hernia

What is Diaphragmatic Hernia?

Diaphragmatic hernia refers to a condition where an abnormal opening allows part of the organs, such as the stomach, intestines, spleen, liver, or kidney from the stomach to move into the chest cavity near the lungs. A diaphragmatic hernia is a rare defect. It happens when the diaphragm does not fully develop while the baby is growing in the womb. The symptoms of this condition may include abdominal pain, problems with breathing and oxygen levels, bluish-colored skin, rapid breathing, and fast heart rate.

Figure 01: Diaphragmatic Hernia

Diaphragmatic hernia can be diagnosed through physical examination, ultrasound, and chest X-ray. Furthermore, diaphragmatic hernia can be treated through breathing support during recovery period, a surgery to place the abdominal organs into proper place, and repair the opening in the diaphragm.

What is Hiatal Hernia?

A hiatal hernia happens when the the upper part of the stomach moves up into the chest through a small opening in the diaphragm, which is called the hiatus. This might be caused by age-related changes in the diaphragm, trauma, or certain types of surgery, being born with a very large hiatus, constant and intense coughing, vomiting, straining during a bowel movement, exercising, or lifting heavy objects. Moreover, the signs and symptoms of hiatal hernia may include heartburn, regurgitation, acid reflux, trouble swallowing, chest or abdominal pain, feeling full soon after eating, shortness of breath, and vomiting of blood or passing of black stool.

Figure 02: Hiatal Hernia

Hiatal hernia can be diagnosed through physical examination, X-ray, endoscopy, and esophageal manometry. Furthermore, treatment options for hiatal hernia may include antacids, medicines to reduce acid production and heal the esophagus (H2 receptor blockers and proton pump inhibitors), and surgery.

Similarities Between Diaphragmatic Hernia and Hiatal Hernia

1. Diaphragmatic hernia and hiatal hernia are two different types of hernias.
2. Both hernias involve herniation through the diaphragm.
3. Both hernias can cause bulging out of the stomach.
4. They can be diagnosed through physical symptoms evaluation and imaging tests.
5. They can be treated through specific surgeries.

Difference Between Diaphragmatic Hernia and Hiatal Hernia

Definition

1. A diaphragmatic hernia happens when the stomach, small intestine, spleen, part of the liver, and the kidney bulge through the diaphragm into the chest cavity.
2. A hiatal hernia happens when the upper part of the stomach bulges into the chest cavity through the diaphragm.

Cause

1. Diaphragmatic hernias can be caused by a birth defect.
2. Hiatal hernia can be caused by age-related changes in the diaphragm, trauma or certain types of surgery, birth defects, and constant and intense pressure on the surrounding muscles.

Symptoms

1. Symptoms of diaphragmatic hernia include abdominal pain, difficulty breathing, tachypnea, blue discoloration of the skin, diminished or absent breath sounds, bowel sounds in the chest area, and less full abdomen.
2. Symptoms of hiatal hernia include heart pain, chest pain, trouble swallowing, bloating, burping, bad taste in the mouth, upset stomach, vomiting, and black flow of food or drink from the stomach to the mouth.

Diagnosis

1. Diaphragmatic hernia can be diagnosed by physical examination, X-ray, ultrasound, CT scan, arterial blood gas test, and MRI.
2. Hiatal hernia can be diagnosed by physical examination, Barium swallow, endoscopy, esophageal manometry, and pH test.

Treatment

1. Diaphragmatic hernia can be treated by open surgery or laparoscopic surgery.
2. Hiatal hernia can be treated by antacids, H2 receptor blockers, proton pump inhibitors, and hiatal hernia surgery.

The following table summarizes the difference between diaphragmatic hernia and hiatal hernia.

Summary – Diaphragmatic Hernia vs Hiatal Hernia

Diaphragmatic hernia and hiatal hernia are two types of hernias. Diaphragmatic hernia occurs when one or more of the abdominal organs, such as the stomach, intestines, spleen, liver, or kidney, move upward into the chest cavity through a defect in the diaphragm, while hiatal hernia occurs when the stomach bulges up into the chest cavity through an opening in the diaphragm. This is the main difference between diaphragmatic hernia and hiatal hernia.

FAQ: Diaphragmatic Hernia and Hiatal Hernia

1. What is the most common site of a diaphragmatic hernia?

• Bochdalek hernia is a type of diaphragmatic hernia that results from a defect in the postero-lateral part of the diaphragm and it is the most common type (70% to 75%). Furthermore, the majority of diaphragmatic hernias occur on the left side and less frequently on the right side.

2. What causes diaphragmatic hernia in newborns?

• Diaphragmatic hernia is a birth defect that can be linked to genetic disorders or mutations. In these cases, the baby may also have more issues at birth, such as problems with the heart, eyes, arms and legs, or stomach and intestine.

3. Does a diaphragmatic hernia always require surgery?

• Diaphragmatic hernia can be present at birth. It is always a medical emergency; therefore, it requires prompt surgery to correct. Diaphragmatic hernia can be treated through open surgery or laparoscopic surgery.

4. What is the root cause of a hiatal hernia?

• Hiatal hernia can be caused by age-related changes in the diaphragm, trauma or certain types of surgery, birth defects, and constant and intense pressure on the surrounding muscles. The risk factors for this problem go up with age, obesity, and smoking.

5. What are the best treatments for hiatal hernia?

• The treatments for hiatal hernia include lifestyle changes and medications (over-the-counter antacids or antihistamines, H2 receptor blockers and proton pump inhibitors) and hiatal hernia surgery.

 Reference:

1. Khalid, Raihan. “Diaphragmatic Hernia: Causes, Symptoms & Diagnosis.” Healthline, Healthline Media.

2. “Hiatal Hernia: Symptoms, Causes, Diagnosis, and Treatment.” WebMD.

Image Courtesy:

1. “Diaphragmatic hernia Wellcome L0061634” By Welcome Images (CC BY 4.0) via Commons Wikimedia

2. “Hiatal Hernia” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia

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