the Management of Hiatus Hernia

- Glossary

Types of hiatus hernia:

The current anatomic classification has evolved to include a categorization of hiatal hernias into Types I – IV, ⁽¹⁾.

1. Type I hernias are sliding hiatal hernias, where the gastroesophageal junction, (GEJ) migrates above the diaphragm, ⁽²⁾. The stomach remains in its usual longitudinal alignment, ⁽³⁾, and the fundus remains below the gastroesophageal junction.

2. Type II hernias are pure paraesophageal hernias (PEH); the gastroesophageal junction remains in its normal anatomic position but a portion of the fundus herniates through the diaphragmatic hiatus adjacent to the esophagus, ⁽²⁾.

3. Type III hernias are a combination of Types I and II, with both the gastroesophageal junction and the fundus herniating through the hiatus. The fundus lies above the gastroesophageal junction, ⁽²⁾.

4.  Type IV hiatal hernias are characterized by the presence of a structure other than stomach, such as the omentum, colon or small bowel within the hernia sac, ⁽²⁾.