Combined Intraluminal Esophageal Pressure Studies with Synchronous Cinefluorography

Improved surgical and anesthetic technics permit removal or correction of esophageal lesions by thoracotomy in an increasing number of patients. For this reason, more precise anatomic and physiologic diagnosis is required. Since criteria for the roentgen diagnosis of hiatal herniation are disputed, and because the clinical significance of minimal to moderate degrees of herniation is often uncertain, a study was undertaken to evolve more specific criteria. A second objective was to evaluate these criteria by applying them to groups of patients in different age groups and over long periods of time. Initially, 300 cinefluorograms of the distal esophagus were reviewed. These were classified in three groups: (a) normal, (b) hiatal herniation, (c) other lesions. These interpretations were compared with the clinical histories of the patients and correlation between the roentgen diagnosis and the clinical impression was found to be poor. A restudy of the same group of cinefluorograms showed considerable intra-and...