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目的:总结食管裂孔疝(EHH)患者口服胃窗造影剂的超声特点，筛选口服胃窗造影剂超声诊断EHH的诊断标准并评估其诊断价值。方法:回顾性收集2023年6－12月因反酸、烧心、嗳气、反复上腹痛、胸痛、咳嗽等症状就诊于中山大学附属第六医院疝和腹壁外科，临床疑诊EHH行口服胃窗造影剂超声检查的患者61例。口服胃窗造影剂超声记录食管裂孔内径、腹段食管长度(IAEL)、His角，膈上疝囊、胃壁滑动征及食管－胃环上移超声征象。回顾性分析所有超声检查资料，以手术或上消化道钡餐及胃镜同时诊断EHH作为金标准，通过ROC曲线分析获得口服胃窗造影剂超声诊断EHH的诊断标准并评估其诊断价值。结果:根据ROC曲线分析得出口服胃窗造影剂超声诊断EHH的指标为食管裂孔内径>15 mm[曲线下面积(AUC)＝0.913]、IAEL≤33 mm(AUC＝0.776)、His角>90°(AUC＝0.735)、膈上疝囊(AUC＝0.913)、胃壁滑动征(AUC＝0.827)、食管－胃环上移(AUC＝0.721)。以食管裂孔内径>15 mm或出现膈上疝囊作为口服胃窗造影剂超声诊断EHH的诊断标准，诊断敏感性、特异性、准确性、阳性预测值、阴性预测值、AUC、95% CI分别为86.5%、100%、88.5%、100%、56.3%、0.933、0.838～0.981。 结论:口服胃窗造影剂超声诊断EHH的最佳诊断标准为食管裂孔内径>15 mm或出现膈上疝囊，具有较高的特异性及阳性预测值，推荐作为筛查EHH的检查方法。

Objective:To summarize the characteristics of oral contrast ultrasound in patients with esophageal hiatal hernia (EHH), to screen the diagnostic criteria for EHH diagnosis by oral contrast ultrasound and to evaluate their diagnostic values.Methods:Sixty-one patients who visited the Hernia and Abdominal Wall Surgery Department of the Sixth Affiliated Hospital of Sun Yat-sen University from June 2023 to December 2023 for symptoms of acid reflux, heartburn, belching, recurrent epigastric pain, chest pain, and cough, and who were clinically suspected of EHH and underwent oral contrast ultrasound were retrospectively collected. The internal diameter of the esophageal hiatus, the length of the intraabdominal esophagus (IAEL), the angle of His, the supradiaphragmatic hernia sac, the sign of gastric wall sliding, and the sign of esophageal-gastric ring uplift were recorded by oral contrast ultrasound. All ultrasonographic data were retrospectively analyzed, and the diagnosis of EHH by surgery or with the simultaneous diagnosis of EHH by barium meal examination and gastroscopy were used as the gold standard. The diagnostic criteria of oral contrast ultrasound for EHH were obtained and their diagnostic values were evaluated by ROC curve analysis.Results:The indicators of EHH diagnosed by oral contrast ultrasound were analyzed according to ROC curves as follows: internal diameter of esophageal hiatus >15 mm (AUC=0.913), IAEL≤33 mm (AUC=0.776), angle of His > 90° (AUC=0.735), supradiaphragmatic hernia sac (AUC=0.913), gastric wall sliding sign (AUC=0.827), upward displacement of the esophagogastric ring (AUC=0.721). The diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value, AUC, and 95% CI of the diagnosis of EHH using the internal diameter of the esophageal hiatus >15 mm or the presence of a supradiaphragmatic hernia sac as the diagnostic criterion for the diagnosis of EHH by oral contrast ultrasound were 86.5%, 100%, 88.5%, 100%, 56.3%, 0.933, and 0.838-0.981, respectively. Conclusions:The optimal diagnostic criterion for EHH diagnosis by oral contrast ultrasound is esophageal hiatal internal diameter >15 mm or the presence of supradiaphragmatic hernia sac, which has 100% specificity and positive predictive value. It is recommended to be widely used as a screening test for EHH in the clinic.