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| Sliding hiatal hernias |
 |
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 |
 |
 |
|
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. |
