There are different anatomic types of hiatal hernias, with differing symptoms and complications.
Parameters:
(1) location of esophagogastric junction
(2) anatomic structures extending into the thorax
|
Location of EG Junction |
Other Structures in Thorax |
Type of Hernia |
|
above the hiatus |
portion of gastric cardia pulled up through hiatus |
Type I |
|
at the hiatus |
portion of gastric fundus herniates through a defect at the hiatus |
Type II |
|
at the hiatus |
most of the stomach herniates through |
Type IIA |
|
above the hiatus |
portion of the gastric fundus herniates through a defect at the hiatus |
Type III (mixed Type I and II) |
|
above the hiatus |
spleen, transverse colon, pancreas or other intraperitoneal structures |
Type IV |
|
below the hiatus |
portion of gastric fundus |
paraesophageal |
where:
• The descriptions of Type II and paraesophageal hernias in Skinner and Belsey seem to overlap. The above is based on the description in Duranceau and Jamieson.
• The thorax is low pressure relative to the abdomen.
|
Common Types of Hernia |
Features |
|
Type I |
"sliding hernia"; reflux common complain; no defect in the phrenoesophageal membrane |
|
Type II |
"rolling hernia"; reflux uncommon; defect in phreno-esophageal membrane with hernia sac present |
Specialty: Gastroenterology
