食管裂孔疝常见、高发，其成因可能与腹腔内压力升高、食管短缩、膈肌薄弱松弛有关。而另外一方面，食管裂孔疝能破坏食管下端的抗返流机制，导致胃食管反流的发生；而反流会引发一系列的心、肺、甚至是耳鼻喉的相关疾病；在Ⅳ型的食管裂孔疝，大量腹腔内脏器、尤其是肠管的进入，会导致慢性肠梗阻的发生；而急性嵌顿的器官，甚至能发生狡窄坏死，危及患者生命。以上的病理生理，是我们了解食管裂孔疝发生、发展及危害的基础。为我们进一步认识、诊治食管裂孔疝提供重要的帮助。本文就食管裂孔疝的病理生理做一阐述。

Hiatal hernia is common and high incidence, and its genesis may be related to elevated intra-abdominal pressure, shortening esophagus and weak diaphragmatic relaxation. On the other hand, hiatal hernia can destroy the anti-reflux mechanism at the lower esophagus, leading to the occurrence of gastroesophageal reflux, while reflux can cause a series of diseases related to the cardiac system, respiratory system and even the otolaryngology. In type Ⅳ hiatal hernia, the entry of a large number of abdominal organs, especially the intestine, can lead to chronic intestinal obstruction, and can even occur incarceration and necrosis, endangering the life of the patient. The all above pathophysiology is the basis for us to understand the occurrence, development and harm of hiatal hernia. It is important for us to further understand and treat esophageal hiatus hernia reasonably. In this paper, we mainly describe the pathophysiology of hiatal hernia.