ArticleBMJ open gastroenterology2021
Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA).
Article in BMJ open gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00005487 (Multi-Ethnic Study of Atherosclerosis), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multi-Ethnic Study of Atherosclerosis (MESA)
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Transthoracic fundoplication using the Belsey Mark IV technique versus Nissen fundoplication: A systematic review and meta-analysis.Surgical endoscopy · 2023Pooled it
- Development of the ParaOesophageal hernia SympTom (POST) tool.The British journal of surgery · 2022Pooled it
- Outcomes of emergent hiatal hernia repair: does specialty matter?Surgical endoscopy · 2026Article
- Effectiveness of Adjunctive Measures to Limit Recurrence and Reoperation After Laparoscopic Repair of Large Paraesophageal Hernias: A Single-Institution Series.Journal of clinical medicine · 2026Article
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- Short term safety and efficacy of robot-assisted laparoscopic redo hiatal hernia repair without mesh: a retrospective cohort study.Journal of thoracic disease · 2026Article
- Large Hiatal Hernia in a Patient With Bulimia Nervosa and Obesity: An Interdisciplinary Case Report.The American journal of case reports · 2026Article
- Endoscopic therapy with Medigus Ultrasonic Surgical Endostapler (MUSE) for gastroesophageal reflux disease: a case description.Quantitative imaging in medicine and surgery · 2025Article
- Article
- Concurrent hiatal hernia repair and gastric bypass as an adjunct in the treatment of hiatal hernia in populations with obesity.Surgical endoscopy · 2025Article
- Risk factors associated with hiatal hernia: a retrospective study and two-sample Mendelian randomization.Surgical endoscopy · 2025Article
- Association of esophageal hiatus size with reflux esophagitis and type I hiatal hernia in patients with obesity.World journal of radiology · 2025Article
- Indirect Inguinal Hernia and Hiatal Hernia in an Elderly Female Cadaver: A Report of a Rare Case.Cureus · 2025Article
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- Preoperative esophagogastroduodenoscopy in pediatric bariatric surgery: A summary of the literature.JPGN reports · 2024Review
- GERD after Roux-en-Y Gastric Bypass: Prevalence and Risk Factors Analysis.Medicina (Kaunas, Lithuania) · 2024Article
- Incidental Extracardiac Findings of Technetium-99m Pyrophosphate Scintigraphy: A Pictorial Review.Cureus · 2024Review
- ENDOSCOPIC MANAGEMENT OF MESH MIGRATION FOLLOWING HIATAL HERNIA REPAIR.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024Article
- Surgical Repair of Large Hiatal Hernias: Insight from a High-Volume Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo determine the prevalence, risk factors and natural history of hiatal hernia (HH) on CT in the general population. MATERIALS AND
methodsThe Multi-Ethnic Study of Atherosclerosis (MESA) acquired full-lung CT on 3200 subjects, aged 53-94 years. Three blinded observers independently determined presence/absence and type (I-IV) of HH. Associations between HH and participant characteristics were assessed via unadjusted and multivariable-adjusted relative risk regression. HH natural history was assessed compared with prior MESA CT.
resultsExcellent interobserver agreement was found for presence (κ=0.86) and type of HH (κ=0.97). Among 316 HH identified (prevalence=9.9%), 223 (71%) were type I and 93 (29%) were type III. HH prevalence increased with age, from 2.4% in 6th decade to 16.6% in 9th decade (unadjusted prevalence ratio (PR)=1.1 (95% CI 1.04 to 1.1)). HH prevalence was greater in women (12.7%) than men (7.0%) (unadjusted PR=1.8 (95% CI 1.5 to 2.3)) and associated with proton pump inhibitor use (p<0.001). In 75 participants with HH with 10-year follow-up, median HH area increased from 9.9 cm
conclusionHH on non-contrast CT is prevalent in the general population, increasing with age, female gender and BMI. Its association with proton pump inhibitor use confirms a role in gastro-oesophageal reflux disease and HH progression is associated with increased BMI. TRIAL REGISTRATION NUMBER: NCT00005487.
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Registered trials
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