What is a Type III esophageal (hiatal) hernia?
Correct Answer
c) Combination of sliding and paraesophageal herniaExplanation
Hiatal hernias are classified based on the position of the gastroesophageal junction and stomach. Type I involves upward displacement of the GEJ into the thorax. Type II has a normally positioned GEJ with part of the stomach herniating alongside the esophagus. Type III is a mixed hernia where both the GEJ and stomach herniate into the thoracic cavity. Option (d) is more consistent with a giant paraesophageal hernia (Type IV).Teaching Points
- Type I is the most common and associated with GERD
- Type III is a mixed hernia involving GEJ and stomach
- Type II and III have higher risk of volvulus and strangulation
- Large hernias with most of the stomach in chest are Type IV