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Hiatus Hernia J016

Last amended 
6 July 2017

In this section

Current RMA Instruments
Reasonable Hypothesis SOP
68 of 2014
Balance of Probabilities SOP
69 of 2014
Changes from previous Instruments

SOP Bulletin 176

ICD Coding
  • ICD-9-CM Codes: 551.3,552.3,553.3
  • ICD-10-AM Codes: K44
Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a diseae or injury

* another SOP applies

# non-SOP condition

Clinical onset

Most hiatus hernias are asymptoamtic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.