Atlas of Gastroenterological Endoscopy
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Sliding hiatal hernias
Sliding hiatal hernia Hernias are classified in 3 categories as axial hiatal hernias, as paraesophageal hernias and as mixed hernias. The axial sliding hernia is the most frequent. The picture shows such a hernia as seen by inversion of the endoscope. The first narrowness in the foreground corresponds to the esophageal penetration through the diaphragm. Visible in the background are those parts of the stomach, which are displaced to the thoracic cavity. The role axial hernias play in the development of reflux esophagitis is not fully understood, since most axial hernias show no esophagitis. In contrast most cases of esophagitis occur in the presence of axial sliding hiatal hernias.
X-ray image of a sliding hiatal hernia
X-ray image of a sliding hiatal hernia Scheme
Vast sliding hiatal hernia. The gastric fundus is dislodged almost completely into the mediastinum. Passing the diaphragm via the esophageal hiatus the stomach gets squeezed considerably.