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THE APPARENT DISPARITY IN INCIDENCE OF HIATAL HERNIAE IN INFANTS AND CHILDREN IN BRITAIN AND THE UNITED STATES

GERALD W. FRIEDLAND M.D., M.R.C.P.E., F.F.R., WYLIE J. DODDS M.D.1, PHILIP SUNSHINE M.D., and F. FRANK ZBORALSKE M.D.

1 Medical College of Wisconsin, 8700 West Wisconsin Avenue, Milwaukee, Wisconsin 53226.

Several roentgenologists in Britain for the past 20 years have annually seen more cases of hiatal herniae in children than have roentgenologists in the United States. The authors decided to determine whether or not the adoption of the criteria employed by some of these British roentgenologists, if used at our hospital in children under the age of 10 years, would result in our finding more cases of hiatal hernia.

A retrospective study of 1 year was done using "British" diagnostic criteria, the results of which were compared to the previous 2 years’ experience in our hospital. We found 10 times more cases of hiatal hernia when these criteria, new to the United States, were employed. Most of the patients were less than a year old, and all patients had severe symptoms attributable to hiatal herniae.

Our findings show that roentgenologists need to be more aware of the roentgen features of hiatal hernia in infants and young children. They should appreciate that the roentgen features differ in the young from older children and adults.


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