Hiatal surface area

Last revised by Calum Worsley on 25 Apr 2024

The hiatal surface area (HSA) is a measurement that has been proposed to define the size of the hiatal defect in the preoperative assessment of a hiatus hernia. It allows to determine the two-dimensional expanse of the hiatal orifice and then adapts the crural closure to the exact dimension of the hiatal orifice.

It is measured using multiplanar reconstructions (MPR) to create a double oblique plane across the diaphragmatic hiatus and drawing a freehand region of interest around the contents of the hiatus 1,2.

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