Fig. 15
a A 79-year-old female with history of (h/o) heartburn on lying down after dinner. Left anterior oblique projection from the contrast oesophagogram identifies herniation of the gastro-oesophageal junction (white arrow) into the thorax; finding is consistent with type I or sliding hiatal hernia. b A 72-year-old male with morbid obesity and recurrent reflux pneumonitis. Lateral projection of a barium oesophagogram identifies intrathoracic herniation of the gastro-oesophageal junction with the gastric fundus, consistent with type III or mixed para-oesophageal hiatal hernia. c A 78-year-old female undergoing preoperative evaluation for transcatheter aortic valve replacement. Axial contrast CT identifies a large hiatal hernia containing stomach, large bowel, splenic vessels and pancreas in the hernia sac, compatible with a type IV hiatal hernia (Movie 2)