The Evaluation of the Esofagogastric Valve, by HILL classification , in the analysis of the RELATIVE RISK of endoscopic occurrence of hiatus hernia and/or esophagitis

Aims To analyze , using the Hill classification ,the frequency of occurrence of HH(hiatus hernia) and/or RE(esophagitis) in the differents types of EGVFlap, and, mainly, the relative risk (RR) of the patient to have these alterations, in according to the type of EGVFlap.

Methods 1474 patients were prospectively evaluated endoscopically the state of EGVFlap and the association, with HH and/or RE. Special emphasis was given to RR analysis of each group with the occurrence of HH/RE. We used, for comparison between the groups, the chi-square procedure, and in situations of low counts we opted for Fisher's exact test. To verify the strength of the association between the type of valve and the abnormalities, we calculated the relative risk and CI 95%. Findings with p<0.05 were considered statistically significant. Programs : WinPepi v10.5 and IBM-SPSS version 25.0 [1] [2].

Results Was observed the type I valve in 1034, with HH, RE, or both, in 117 cases (11.3%). The type II was in 342 patients with HH, RE, or both, in 122 cases (35.7%). The type III in 80 patients with HH, RE or both in 72 cases (90.0%). And the type IV was in 18 cases and in all 18 there was HH, or RE, or both (100.0%). The comparative analysis of the finding of RE in the 4 different types was statistically significant (p< 0.0001), and the same with HH in the 4 different types (p< 0.0001), and also with RE + HH, in the 4 different types, (p< 0.0001).The RR CI 95% was very significative in all analysis , how shows the conclusions ([Table 1]).

Table 1

Conclusions With Hill Classification, was observed an RR (95% CI) of having HH and/or RE, in the different types of valve, of the order of 3.16 x > if it has type II, 7.94 x> if it has type III, and 8.84 x> if it has type IV.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• 1 Hill LD., Kozarek RA.. et al. Seattle, Washington The gastroesophageal flap valve: in vitro and in vivo observations. Gastrointest Endosc 1996; 44: 541-7
• 2 Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006; 101 (08) 1900-1920

Publication History

Article published online:
14 April 2023