[What is the place of conventional radiology in the exploration of esophageal dyskinesia and hiatal hernia?].
Esophageal dyskinesias are due to various aetiologies and sometimes present with marked clinical symptoms. The barium swallow remains the preferred first-line examination. Upper GI endoscopy and manometry are useful to confirm the functional nature and eliminate any concomitant or secondary mucosal lesions of these motor disorders. The clinical signs of hiatus hernia are essentially due to complications related to gastro-esophageal reflux. They can be asymptomatic or may present in the form of atypical, sometimes extra-gastrointestinal, symptoms. Although conventional radiology allows the diagnosis of hiatus hernia by specifying the type, the morphology and the anatomical relations, it may fail to detect the consequences of gastro-esophageal reflux, especially ulcerated lesions. Upper gastrointestinal endoscopy appears to be the first-line examination of choice for the diagnosis of hiatus hernia. Barium swallow is useful in cases of failure of endoscopy and in the context of preoperative assessment, as these two investigations are often complementary.