To explore the significance of multislice spiral CT hernia sac and intraperitoneal volume measurement in clinical treatment of giant hiatus hiatal hernia.

The clinical data of 15 cases that were diagnosed as esophageal hiatus in People′s Hospital of Xinjiang Uygur Autonomous Region from June 2015 to February 2016 were collected.The abdominal scan was performed by 64 slice spiral CT, and the volume of the hernia sac and abdominal cavity were measured by three-dimensional reconstruction technique.

15 patients′sac minimum volume was about 166.5 cm³, a maximum of them was 1 080.6 cm³, average volume was(569.9±268.0)cm³.Pleural minimum volume was 2 136.3 cm³, the maximum was 6104.2 cm³, average volume was(3 615.9±1 061.1)cm³.Intraperitoneal volume minimum was 4 436.9 cm³, the maximum was 12 630.2 cm³, and average volume was(9 540.2±2 618.9)cm³.Sac volume/volume ratio of the abdominal cavity, the maximum value was 19.6%, the minimum value was 2.30%, and the average was(6.69%±4.6%). A hernia opening maximum diameter was 5.45 cm, the minimum was 2.66 cm, the average value of the hernia orifice diameter was(3.89±0.85)cm.Clinical follow-up of 15 cases and 10 cases of preoperative evaluation, surgical treatment, cured; 1 patient had postoperative hernia recurrence, pulmonary infection, pleural effusion; 1 case of postoperative infection, respiratory failure; 1 patient with advanced age did not surgery; 1 case of overweight, weight loss was recommended after further treatment; 1 patient discharged.

Multislice spiral CT planar reconstruction technology could clearly show the esophageal hiatal hernia diaphragmatic hernia sac shape, content and the surrounding adjacent relationship.The size of hernia, hernia sac volume and abdominal volume could be measured, for the clinical classification of esophageal hiatal hernia and clinical treatment.And a basis for decision-making; a huge incidence of surgical complications of hiatal hernia hiatus could be provided through the hernia sac/peritoneal volume measurement to assess the degree of surgical risk and avoid serious surgical complications.