Three types of hiatus hernia are distinguished. Axial hiatus hernia (synonyms: axial sliding hernia, type I hiatus hernia), in which the esophagogastric ...SkiptocontentsuchenGenericfiltersHiddenlabelHiddenlabelHiddenlabelHiddenlabelHomeClassificationsHiatusherniasandtheHillclassificationHiatusherniasandtheHillclassificationPriv.-Doz.Dr.med.F.Seyfried,JanaMayOberarztderKlinikundPoliklinikfürAllgemein-,Viszeral-,Transplantations-,Gefäß-undKinderchirurgieUniversitätsklinikumWürzburgHerniationofthestomachthroughtheesophagealhiatusintothemediastinumisknownashiatushernia.Itisafrequentincidentalfindingduringgastroscopy.Theprevalenceoftheconditionincreaseswithincreasingageandwhenthereisraisedintra-abdominalpressure(e.g.,inobesityorpregnancy).Malesexisalsoariskfactorforthepresenceofhiatushernia[1].Threetypesofhiatusherniaaredistinguished.Axialhiatushernia(synonyms:axialslidinghernia,typeIhiatushernia),inwhichtheesophagogastricjunctionandsometimesthecardia“slide”inasupradiaphragmaticdirection,isthemostfrequenttype,representingmorethan90%ofcases.Dependingonitsseverity,itcancausespatialdissociationofthecomplexsphinctermuscleapparatus,consistingofthediaphragmaticcruraandsmooth-musclewallofthecardia.Thiscanleadtoinsufficiencyofsphinctermusclefunctionintheareaoftheloweresophagealsphincter.Axialhiatusherniamaybe,butisnotnecessarily,associatedwithgastroesophagealrefluxdisease.Anindicationfortreatmentofaxialhiatusherniaisonlypresentwhenthereisfunctionalevidenceofrefluxdisease,secondarydisturbanceofesophagealmotility,orvolumereflux.Whenotherpartsofthestomachthantheesophagogastricjunctionorcardiaherniateinasupradiaphragmaticdirectionandthuscometoliealongsidetheesophagus,theconditionisdescribedasparaesophagealhiatushernia(synonym:typeIIhiatushernia).Themaximalvariantofthisiscompletethoracicstomach(knownas“upside-downstomach”).AmixedformconsistingofaxialslidingherniaandparaesophagealherniarepresentstypeIIIhiatushernia.TypesIIandIIIhiatusherniaaremuchmorerare,andduetothepotentialcomplica